ORIGINAL RESEARCH article
Front. Cardiovasc. Med.
Sec. Heart Valve Disease
Analysis of risk factors and construction of nomogram model for cardiac valve calcification of patients undergoing hemodialysis
Yan Zhang 1,2
Lin Huang 1,2
Mengjun Tao 2
Jiajun Zhou 2
Deguang Wang 1
1. The Second Affiliated Hospital of Anhui Medical University, Hefei, China
2. Yijishan Hospital of Wannan Medical College, Wuhu, China
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Abstract
Objective This study aimed to construct a risk prediction nomogram model of cardiac valve calcification (CVC) in patients undergoing maintenance hemodialysis (MHD) and to verify its evaluation effect. Methods A total of 398 patients undergoing hemodialysis were randomly divided into a modeling group (n = 274) and a validation group (n = 124). In the modeling group, 92 patients had CVC and 182 did not. Multivariate logistic regression analysis was conducted to determine the risk factors for CVC in patients undergoing hemodialysis. A nomogram prediction model was constructed using R software, and its predictive performance was evaluated in terms of discrimination, calibration, and clinical utility. Results This study included 398 patients undergoing MHD with a mean age of 51.17±14.09 years, and the prevalence of CVC was 31.66%. Compared with the non-CVC group, patients in the CVC group were older and had a higher proportion of males, longer dialysis duration, higher prevalence of diabetes, and higher levels of total cholesterol, triglycerides, and fat tissue index, while handgrip strength was significantly lower ( all P < 0.05 ). Multivariate logistic regression analysis identified age (OR = 1.052, 95%CI = 1.028-1.077), male sex (OR = 3.164, 95%CI = 1.679-5.962), dialysis duration ≥36 months (OR = 2.096, 95%CI = 1.162-3.781), total cholesterol level (OR = 1.582, 95%CI = 1.191-2.101), and fat tissue index (OR = 1.128, 95%CI = 1.046-1.217) as independent risk factors for CVC (all P < 0.05). The area under the receiver operating characteristic curve (AUC) of the nomogram in the modeling group was 0.789, indicating good discriminative ability. The calibration curve demonstrated good agreement between predicted and observed outcomes. In the validation group, the AUC was 0.751, with calibration curve closely aligned with the ideal reference line. Decision curve analysis (DCA) further confirmed the clinical utility of the nomogram. Conclusion Patients undergoing hemodialysis who are older, male, have a dialysis duration ≥36 months, elevated total cholesterol levels, and increased fat tissue index are at higher risk of developing CVC. The nomogram model demonstrated good predictive performance for CVC in patients undergoing hemodialysis.
Summary
Keywords
Cardiac valve calcification, Fat tissue index, hemodialysis, nomogram, Risk factors
Received
29 July 2025
Accepted
30 January 2026
Copyright
© 2026 Zhang, Huang, Tao, Zhou and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Deguang Wang
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