The Japanese Journal of Clinical Dialysis Vol.22 No.4(6-1)

Theme Cardiovascular Complications in Chronic Dialysis Patients -- Are They Inevitable?
Title Valvular heart disease in hemodialysis patients -- internal medicine viewpoint
Publish Date 2006/04
Author Yoshihiko Otsubo Department of Cardiology, Tenjin-Kai Shin-Koga Hospital
Author Nobuhiko Koga Department of Cardiology, Tenjin-Kai Shin-Koga Hospital
[ Summary ] Valvular heart disease (VHD) occurs more frequency in hemodialysis (HD) patients than in normal subjects. Aortic valve calcification (AVC) and mitral annular calcification (MAC) are characteristic symptoms that occur in HD patients, causing aortic stenosis (AS), mitral regurgitation (MR) and aortic regurgitation (AR). Cardiac valve calcification is associated with a advanced age, long term HD therapy, disturbances in the calcium-phosphate metabolism, and treatment with phosphate binders. The symptoms observed in HD patients are similar to those seen in non-dialysis patients, however, the progression tends to be more rapid. Diagnosis is done mainly with echocardiography. When treating VHD, the control of such dialysis-specific factors as volume overload, anemia, and metabolic disturbances is required, in addition to the administration of general treatment for heart failure. In addition, infective endocarditis (IE) frequently occurs in HD patients and it is often associated with an unfavorable prognosis.
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