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Assessment of Vascular Function in Patients With Chronic Kidney Disease
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Prospective evaluation of aortic stenosis in end-stage kidney disease: a more fulminant process?

Dominica Zentner1, David Hunt, William Chan

  • 11Department of Cardiology, Royal Melbourne Hospital, Melbourne VIC, Australia. dominica.zentner@mh.org.au

Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association
|September 30, 2010
PubMed

Insights

Patients with end-stage kidney disease and aortic stenosis (AS) face worse outcomes. Early aortic valve replacement (AVR) is recommended for these patients once moderate to severe AS is detected.

Area of Science:

  • Cardiology
  • Nephrology
  • Valvular Heart Disease

Background:

  • Previously observed accelerated aortic stenosis (AS) progression in end-stage kidney disease (CKD 5D) patients.
  • CKD 5D patients with AS exhibit a faster disease progression compared to controls.

Purpose of the Study:

  • To prospectively follow a cohort of CKD 5D patients with AS.
  • To determine major event-free survival (aortic valve replacement or death) in CKD 5D patients with AS compared to controls.

Main Methods:

  • Re-matched CKD 5D cohort (n=27) to a control cohort (n=27) based on aortic valve area (AVA).
  • Utilized AVA as the primary matching variable due to its significance in AS progression rate.

Main Results:

  • 100% of CKD 5D patients underwent aortic valve replacement (AVR) or died.
  • 63% of control patients underwent AVR or died; 9 remained event-free.

Conclusions:

  • Controls demonstrated significantly greater major event-free survival (P=0.001).
  • Suggests early AVR consideration for CKD 5D patients with moderate to severe AS, irrespective of symptoms.
Abstract

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