Vascular Calsification Disorders In End Stage Renal Disease. A Study On: Value Of Calcium-Phosphate Multiplication Products, Intact Paratiroid Hormones, Calsification Of Abdominal Aorta And Heart Valves

Introduction. Vascular calcification are the late complications of patients with End Stage Renal Disease (ESRD). Decreased renal excretion causes phosphate retention which results in hypocalcemia, which then stimulates the secretion of parathyroid hormone. This mineral metabolic disorder does not only occur in bones, but also in the vascular which plays an important role in the increase risk of death in patients with chronic kidney disease.

Aim. To investigate the association between calcium-phosphate multiplication products and intact parathyroid hormone (iPTH) level with calcification of abdominal aorta and heart valves in subjects with ESRD.

Method. This is an observational-analytic cross-sectional study conducted at Prof.dr.R.D. Kandou Hospital, Manado from January to April 2018. There were 40 patients with ESRD who met the inclusion and exclusion criteria. The parameters examined were calcium, albumin, phosphate, iPTH level, lateral abdominal photos to assess the abdominal aortic calcification and echocardiographic to assess the heart valve calcification.

Results. There was no positive correlation between calcium-phosphate multiplication product with iPTH level in ESRD patients (p=0.060, r=0.299). There was no significant correlation between calcium-phosphate multiplication product with abdominal aortic calcification in ESRD patients (p=0.442, RP=0.667). There was no significant correlation between calcium-phosphate multiplication product with heart valve calcification in ESRD patients (p=1.000, RP=1.111). There was no significant relationship between iPTH level with abdominal aortic calcification in ESRD patients (p=0.121, RP=1.667). There was a significant correlation between iPTH level and heart valve calcification in ESRD patients (p=0.037, RP=1.889, OR=4.048).

Conclusion. In ESRD patients, there was no significant weak positive correlation between calcium-phosphate multiplication product with iPTH level, no significant correlation between calcium-phosphate multiplication product with abdominal aorta calcification and cardiac valves calcification and no significant correlation between iPTH level with abdominal aortic calcification. There was a significant relationship between iPTH and heart valve calcification in ESRD patients.