PREDICTIVE VALUE OF MITRAL AND AORTIC-VALVE SCLEROSIS FOR SURVIVAL INEND-STAGE RENAL-DISEASE ON CONTINUOUS AMBULATORY PERITONEAL-DIALYSIS

To determine whether mitral valve or anular sclerosis or calcification (MC) is associated with reduced survival in patients with end-stage r enal disease on continuous ambulatory peritoneal dialysis (CAPD), 53 C APD patients were followed with echocardiography and Doppler echocardi ography over 35 months. Both nonsurvivors and survivors with MC had hi gher systolic blood pressure before CAPD and calcium-phosphorus produc ts during CAPD treatment than patients without MC (p < 0.05). Serum ca lcium and phosphorus concentrations, alkaline phosphatase and parathyr oid hormone activities were higher in nonsurvivors and survivors with than without MC (p > 0.05). Left ventricular end-diastolic and end-sys tolic volumes were greater (p < 0.01), ejection fractions were smaller (p < 0.05) in nonsurvivors with than without MC, but not in survivors with versus without MC. Severe MC and grade Ill mitral valve regurgit ation were more frequent in nonsurvivors than in survivors (p < 0.03). No valvular stenoses were found. It is concluded that the development of MC is favored by long-standing predialysis arterial hypertension a nd by high calcium-phosphorus products during CAPD. Nonsurvivors with MC are characterized by reduced systolic left ventricular function or severe valvular lesions. A close cardionephrologic cooperation is nece ssary to improve the survival of CAPD patients with these risk factors .