Heart Valve Disease And Disorders Related To Mineral Metabolism In Hemodialysis Patients At Dr. Soetomo Regional Hospital In Indonesia: The Mediator Function Of Valve Calcification

Abstract

Malnutrition, chronic inflammation, and problems with mineral metabolism are frequently linked to calcification in patients with chronic kidney disease (CKD) receiving hemodialysis (HD). The purpose of this study is to examine the connection between heart valve problems and levels of calcium, phosphorus, albumin, and C-reactive protein (CRP) in patients with chronic kidney disease (CKD) receiving hemodialysis. This cross-sectional observational analytical study was carried out at Surabaya's Dr. Soetomo General Hospital. Laboratory testing provided information on calcium, phosphate, albumin, and CRP levels, and transthoracic echocardiography (TTE) was used to evaluate heart valve problems. The Spearman correlation test was used for the correlation analysis, with a significance level of p < 0.05. Most participants had normal albumin levels (98.3%), high CRP (65%), hyperphosphoremia (68.3%), and normal calcium levels (56.7%). The most prevalent valve condition (66.7%) with mild severity (60%) was mitral regurgitation. Heart valve calcification was substantially correlated with calcium, phosphorus, and CRP levels (r = 0.430; p = 0.001; r = 0.296; p = 0.022; r = 0.262; p = 0.043), but not with albumin levels (p > 0.05). The degree of heart valve damage was only substantially correlated with calcium levels (r = 0.290; p = 0.025). Furthermore, there was a significant correlation (r = 0.365; p = 0.004) between the degree of heart valve dysfunction and valve calcification. The degree of heart valve damage in CKD patients receiving hemodialysis was substantially correlated with calcium levels and valve calcification. One of the main mediators between clinical signs of heart valve deterioration and problems with mineral metabolism is valve calcification.