While patients with end-stage renal disease treated by intermittent hemodialysis have frequent and progressive valve disease, nothing is known of the prevalence and course of valvular abnormalities in patients treated with continuous ambulatory peritoneal dialysis (CAPD). Therefore, valves of 24 CAPD patients (ages 55 +/- 11 years; CAPD duration: 29 +/- 28 months) were studied in a prospective echocardiographic and Doppler echocardiographic follow-up analysis over 35 months. Most frequent findings were sclerosis of the aortic annulus (100% at both assessments) and of the anterior mitral valve leaflet (first vs. follow-up assessment: 88 vs. 96%). Sclerosis of the mitral valve annulus (58% vs. 63%), right coronary (54 vs. 63%) and noncoronary (50 vs. 67%) cuspis of the aortic valve and of the posterior mitral valve leaflet (25 vs. 50%) were less frequent but tended to be progressive (p = NS). The moderate form of mitral and aortic valve sclerosis was more frequent than the severe form (p < 0.01 each) at both assessments. Patients with progressive valve disease were older (60 +/- 9 vs. 50 +/- 11 years; p < 0.025) and had a higher frequency angina pectoris than those without a progression (5 vs. 0 patients; p < 0.05). The number of patients with regular sinus rhythm decreased (from 22 to 16; p < 0.03), atrial fibrillation developed in four patients, atrioventricular node rhythm following atrioventricular conduction defect developed in one patient, and atrioventricular conduction defect required implantation of a pacemaker in one patient.(ABSTRACT TRUNCATED AT 250 WORDS)