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Updated: Mar 12, 2026
Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
Mean Transaortic Gradient is an Emerging Predictor of Chronic Kidney Disease in Elderly Patients
Ingrid Platania1, Valentina Terranova1, Salvatore Davide Tomasello2
11 Department of Clinical and Experimental Medicine, Unit of Internal Medicine, Cannizzaro Hospital, University of Catania, Catania, Italy.
Insights
Arterial hypertension does not predict chronic kidney disease (CKD) in elderly patients with aortic stenosis (AS). Instead, age, diabetes mellitus, and mean transaortic gradient are independent CKD predictors.
Area of Science:
- Cardiology
- Nephrology
- Geriatrics
Background:
- Arterial hypertension (AH) is a known risk factor for chronic kidney disease (CKD).
- The role of AH in CKD development among elderly patients with aortic stenosis (AS) is not well-defined.
- The influence of transaortic gradient on CKD in this population requires further investigation.
Purpose of the Study:
- To evaluate the relationship between aortic stenosis (AS) and chronic kidney disease (CKD) in hospitalized elderly patients.
- To determine the independent predictors of CKD in this cohort, specifically examining the roles of arterial hypertension (AH) and mean transaortic gradient.
Main Methods:
- Prospective recruitment of 346 hospitalized patients (mean age 79.5 years).
- Transthoracic echocardiography for AS assessment and CKD-Epi Collaboration formula for renal function evaluation.
- Multivariate analysis to identify independent predictors of CKD.
Main Results:
- Age, diabetes mellitus (DM), and mean transaortic gradient were identified as independent predictors of CKD (P <.01, P = .02, P = .03, respectively).
- Arterial hypertension (AH) was not an independent predictor of CKD in this cohort.
- Each 1 mm Hg increase in mean transaortic gradient was associated with a 2.5-fold increase in CKD risk.
Conclusions:
- In elderly patients with aortic stenosis, arterial hypertension is not an independent predictor of chronic kidney disease.
- Mean transaortic gradient, age, and diabetes mellitus are significant independent predictors of CKD in this population.
- Elevated transaortic gradient significantly increases the risk of developing chronic kidney disease.
Abstract:
Arterial hypertension (AH) is a major risk factor for chronic kidney disease (CKD). However, whether AH maintains this role in the development of CKD in elderly patients with aortic stenosis (AS) or whether transaortic gradient influences CKD remains unclear. Consecutive hospitalized patients were prospectively recruited to evaluate the relationship between AS and CKD. In all patients, transthoracic 2-dimensional echocardiography was performed to evaluate AS; renal function was evaluated using the Chronic Kidney Disease Epidemiology Collaboration formula. A total of 346 patients were included in the study (mean age: 79.5 ± 7.4 years): 104 had diabetes mellitus (DM), 298 had AH, and 59 (moderate: 52; severe: 7) showed AS. After multivariate analysis, age ( P <.01), DM ( P = .02), and mean transaortic gradient ( P = .03), but not AH, were independent predictors of CKD. Both in the presence (n = 59) or absence (n = 287) of AS, the estimated glomerular filtration rate did not differ in patients with (51 ± 24 mL/min/1.73 m2 and 59 ± 25 mL/min/1.73 m2, respectively) and those without AH (50 ± 21 mL/min/1.73 m2 and 65 ± 24 mL/min/1.73 m2, respectively). In the whole population, for each mm Hg of mean transaortic gradient, the risk of CKD increased by 2.5 times.
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