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Progression of cardiac valve calcification and decline of renal function in CKD patients.

Abstract：

BACKGROUND:No study has evaluated the efficacy of non-calcium-containing phosphate binders in slowing progression of cardiac valve calcification or deterioration of kidney function in patients with chronic kidney disease not on dialysis. This study addressed these issues. METHODS:Outpatients (n = 170) with stage 3-4 chronic kidney disease and either mitral or aortic valve calcification were evaluated in this single-center, single-arm, prospective observational study. Patients received sevelamer hydrochloride (1,600 mg/day) for 1 year. Cardiac valve calcification progression was assessed by echocardiography, and decline of renal function by estimated glomerular filtration rate. Parathyroid hormone, FGF-23 and C-reactive protein (CRP) serum concentration and urinary phosphorus excretion were assayed. RESULTS:At the end of treatment with sevelamer (12th month), mitral valve calcification had decreased by 79.3% from baseline. At baseline, 69 patients had grade 1, 97 patients grade 2 and 4 patients grade 3 calcification scores; at the end of the study, 60 patients showed grade 1, and no mitral valve calcification was registered in the remaining patients. An aortic valve score of 1 was found in 32%, score of 2 in 58%, score of 3 in 9% and score of 4 in 1% of patients at baseline; at the end of the study, a score of 1 was found in 95% and a score of 2 in 5% of patients. Significant slowing down of renal function decline (p<0.001), reduction of FGF-23 and CRP concentration (p<0.0001) and phosphorus excretion (p<0.0001) were observed. CONCLUSIONS:One-year treatment with a non-calcium-containing phosphate binder may hamper the progression of cardiac valve calcification and slow the decline of renal function, as well as reduce serum concentration of FGF-23 and CRP and urinary phosphorus excretion.

journal_name

J Nephrol

journal_title

Journal of nephrology

authors

Di Lullo L,Floccari F,Santoboni A,Barbera V,Rivera RF,Granata A,Morrone L,Russo D

doi

10.5301/jn.5000290

subject

Has Abstract

pub_date

2013-07-01 00:00:00

pages

739-44

issue

eissn

1121-8428

issn

1724-6059

pii

E664A418-D0CD-4B08-BB4D-FD254C570F25

journal_volume

pub_type

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Progression of cardiac valve calcification and decline of renal function in CKD patients.