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Kidney Dysfunction and the Risk of Developing Aortic Stenosis.
Georgios Vavilis1, Magnus Bäck2, Giuseppe Occhino3
1Department of Medicine, Karolinska Institute, Huddinge, Stockholm, Sweden; Theme of Heart and Vessels, Division of Coronary and Valvular Heart Disease, Karolinska University Hospital, Stockholm, Sweden; Functional Area of Emergency Medicine, Karolinska University Hospital, Huddinge, Stockholm, Sweden.
Journal of the American College of Cardiology
|January 26, 2019
Summary
Chronic kidney disease (CKD) is linked to a higher risk of developing aortic stenosis (AS). This association holds true even in moderate to severe stages of CKD, highlighting a significant connection between kidney function and heart valve health.
Area of Science:
- Cardiology
- Nephrology
- Epidemiology
Background:
- Chronic kidney disease (CKD) and aortic stenosis (AS) share common risk factors.
- Investigating the link between kidney dysfunction and AS development is crucial for understanding cardiovascular health.
Purpose of the Study:
- To evaluate the association between kidney dysfunction, measured by estimated glomerular filtration rate (eGFR), and the incidence of aortic stenosis (AS) in a large community cohort.
- To determine if reduced kidney function increases the risk of developing AS.
Main Methods:
- Utilized data from the Stockholm CREAtinine Measurements (SCREAM) project, including 1,121,875 citizens.
- Calculated eGFR from serum creatinine and ascertained AS incidence through clinical diagnostic codes.
- Employed multivariable Cox proportional hazards models and conducted sensitivity analyses to assess reverse causation and heart failure comorbidity.
Main Results:
- A total of 66,949 participants (6.0%) had CKD (eGFR <60 ml/min/1.73 m²).
- During a median follow-up of 5.1 years, 5,858 individuals developed AS.
- Lower eGFR strata were significantly associated with higher hazards of AS, with eGFR ≤44 ml/min/1.73 m² indicating an approximate 20% increased risk.
Conclusions:
- Chronic kidney disease (CKD), including moderate to severe stages, is independently associated with an increased risk of developing aortic stenosis (AS).
- These findings underscore the importance of considering kidney function in the assessment and management of patients at risk for AS.
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