N.M. Andonieva, T.L. Valkovskaya, A.V. Lesova

The possibility of using osteopontin as a marker of calcification of the heart valve apparatus in patients with chronic kidney disease on replacement therapy by hemodialysis

Aim of research. To identify a possible relationship between the degree of violation of phosphorus-calcium metabolism and the intensity of the processes of calcification of heart valves in patients with chronic kidney disease on hemodialysis.

Materials and methods. 51 patients with CKD stage 5 were examined. The level of calcium, serum phosphorus, calcium-phosphorus product was estimated, the level of parathyroid hormone, osteopontin was determined. Echocardiographically, the presence or absence of aortic and mitral valve calcification was assessed.

Results. We revealed calcinosis of heart valves in 39.2% of patients: combined mitral-aortic calcinosis was observed in 21.5% of patients, isolated calcinosis of mitral valve - in 13.7%, isolated calcinosis of aortic valve was observed in 3.9%. Hyperphosphatemia (PЈ0.033) and an increase in the product of CaxP concentration above 5.0 (PЈ0.002) were statistically significant in the development of calcification of cardiac structures. Parathyroid hormone levels were statistically higher in the groups of patients with calcinosis and heart valve compaction (pЈ0.001) than in patients without calcinosis. Osteopontin indices were higher in the group of patients with calcinosis than in patients with compaction of heart valves (PЈ0.001) and significantly higher than in patients without calcification of heart structures (PЈ0.05).

Summary. Calcification of heart valves in hemodialysis patients is associated with an increase in plasma concentrations of osteopontin, parathyroid hormone, calcium-phosphorus metabolism. Positive correlation between the level of osteopontin and the degree of heart valve damage allows to use it as a marker of cardiovascular calcification.