Carotid Artery Intima-Media Thickness and Heart Valve Calcifications in Hemodialysis Patients with Hyperparathyroidism (A Pilot Study)

Author(s): Isa Ardahanli, Mehmet Serdar Cengizhan, Mehmet Celik, Saadet Kader, Mustafa Akarslan, Mumtaz Takir

Objective: Cardiovascular disease (CVD) is currently the leading cause of morbidity and mortality in patients with end-stage renal disease (ESRD). The aim of this study was to examine carotid artery intima-media thickness (CIMT) and valvular calcification in asymptomatic hemodialysis (HD) patients, to compare them with healthy subjects, and to identify risk factors associated with atherosclerosis.

Materials and Methods: Forty-nine HD patients and age and sex-matched 48 healthy volunteers were enrolled in this study. Right and left carotid intima-media thicknesses (CIMTs) were measured, and echocardiographic evaluation of valve calcification was performed. CaxP product and parathormone (PTH) values were measured from venous blood samples.

Result: The mean CIMT thicknesses were 0.86 ± 0.16 mm in the patient group and 0.61 ± 0.11 mm in the control group. Mean CIMT was significantly higher in the patient group (p <0.001) and valve calcification was measured as 53% in the patient group. Aortic valve calcification in 22.5%, mitral valve calcification in 18.3%, and calcification in both valves in 12.2%. The rate of valve calcification in the control group was 10.4%. In the HD group, the mean PTH level was 578.2 pg/ml and in the healthy control group was 36.2 pg/ml. The CaxP product was significantly higher in the dialysis group than in the control group (p <0.001) (53.9 ± 11.5-33.6 ± 4.1, respectively). PTH value and CaxP product height correlated significantly with valve calcification and CIMT.

Conclusion: CIMT was more prominent as a sign of atherosclerotic development in HD patients and valve calcification was more frequent. In addition to classical risk factors, we have concluded that the uremic environment may contribute to an