Relationship between Calcium-Phosphorus Product and Severity of Valvular Heart Insufficiency in Patients Undergoing Chronic Hemodialysis

Background: recent interests have mainly focused on the roles of serum calcium and phosphorus and their product (ca-p product) in the development of valvular heart disease. the present study assessed the relationship between the ca-p product and the severity of valvular heart disease in end-stage renal disease (esrd) patients undergoing chronic hemodialysis.methods: this cross-sectional study reviewed the clinical course of 72 consecutive patients with the final diagnosis of esrd candidated for chronic hemodialysis. the severity of valvular heart disease was determined using m-mode two-dimensional echocardiography. the serum calcium and phosphate values adopted were those values measured on the day between the two consecutive dialyses, and the ca-p product was calculated. results: the most common causes of esrd were diabetic nephropathy, malignant hypertension, and chronic glomerulonephritis. the mean ca-p product level in the dialysis patients was 50.44 ± 17.78 mg2/dl2. the receiver-operator characteristic (roc) curve illustrated that a ca-p product level > 42 mg2/dl2 was the optimal value in terms of sensitivity and specificity for predicting the presence of valvular insufficiency. aortic insufficiency was directly associated with a high ca-p product value after adjustment for age, gender, serum albumin, diabetes, hypertension, hyperlipidemia, coronary artery disease, and serum creatinine ((beta) = 0.412, se = 158, p value= 0.011). conclusion: a positive relationship between the ca-p product value and the severity of aortic insufficiency is expected. achieving an appropriate control of the ca-p product level may decrease aortic valve calcification and improve the survival of patients on chronic hemodialysis.