Cardiac valve calcification and risk of cardiovascular or all-cause mortality in dialysis patients: a meta-analysis

Background: Vascular calcification is a risk factor for the pathogenesis of cardiovascular disease and mortality in dialysis patients. Nevertheless, the association between cardiac valve calcification (CVC) and the outcome of dialysis is still illusive. The purpose of this meta-analysis is to evaluate the association between the CVC and cardiovascular or all-cause mortality in dialysis patients. Methods: Literatures involving the baseline CVC and cardiovascular or all-cause mortality in dialysis patients were searched from the PubMed, Embase, as well as two Chinese databases (i.e. Wanfang and CNKI databases). Articles published before November 2016 were eligible to the study. Results: Ten studies involving 2686 participants were included. CVC was correlated with increased risk of cardiovascular mortality (hazard risk [HR]: 2.81; 95% confidence intervals [CI]: 1.92-4.10) and all-cause mortality (HR: 1.73; 95% CI: 1.42-2.11). Subgroup analysis showed an excess risk of all-cause mortality (HR: 1.35; 95% CI: 1.02-1.79) among patients with one CVC, and increased risk of all-cause mortality in patients with two CVCs (HR 2.15; 95% CI 1.57-2.94). Conclusions: CVC is correlated with higher cardiovascular and all-cause mortality risk in dialysis patients. Regular follow-up monitoring of CVC may be helpful for risk stratification of patients underwent dialysis.