Jg. Hakim et al., VALVULAR HEART-DISEASE IN END-STAGE RENAL-FAILURE PATIENTS ON MAINTENANCE HEMODIALYSIS, Saudi medical journal, 16(3), 1995, pp. 222-226
Objective: To determine the presence of, and factors associated with,
valvular heart disease in end-stage renal failure patients by M-mode,
two-dimensional and Doppler echocardiography. Design: Case series of a
n unselected group of patients on maintenance haemodialysis. Setting:
Haemodialysis unit and echocardiography laboratory of the King Fahd Ce
ntral Hospital, Gizan, Saudi Arabia. Subjects: Sixty patients on haemo
dialysis for at least 6 months. Main outcome measures: Detection of fu
nctional and structural valve abnormalities and their relation to puta
tive aetiological factors. Results: The mean age was 34.4 (SD13.0), ra
nge 14-66 years; 31 (51.7%) were men and 29 women. The duration of dia
lysis was 37 (SD 29) months with a range of 6-106 months. Mitral regur
gitation was found in 20 (33.3%), mitral annular calcification in 3 (5
.0%), aortic valve calcification in 5 (8.3%) and tricuspid regurgitati
on in 8 (13.3%) patients. At least one of these lesions was present in
22 (36.7%) patients. No patient had mitral or aortic stenosis. There
were significant associations found between left ventricular mass and
mitral regurgitation; calcium-phosphate product and aortic valvular ca
lcification; and right ventricular enlargement and tricuspid regurgita
tion. Conclusions: Mitral and tricuspid regurgitation were common in o
ur dialysis patients. The calcium and phosphate product was found to b
e an important determinant of aortic valvular calcification. Further s
tudies are needed to determine whether early control of calcium and ph
osphate levels would prevent the development of this complication.