[Valvular heart disease in patients with chronic kidney disease]

Area of Science:

• Cardiology
• Nephrology

Background:

• Valvular heart disease frequently coexists with impaired renal function, particularly end-stage renal disease (ESRD) requiring dialysis.
• Sclerosis and calcification of cardiac valves, especially aortic and mitral valves, are key contributors to valvular dysfunction (stenosis or insufficiency) in these patients.

Purpose of the Study:

• To review the challenges and treatment options for valvular heart disease in patients with chronic kidney disease (CKD).
• To highlight the role of interventional cardiology in managing severe valvular heart disease in patients with CKD and high surgical risk.

Main Methods:

• Review of current European Society of Cardiology guidelines (2017).
• Analysis of clinical outcomes comparing surgical and interventional approaches in CKD patients.
• Discussion of emerging catheter-based treatment options.

Main Results:

• Surgical treatment is standard for severe valvular heart disease but associated with poorer outcomes and higher mortality in CKD patients.
• Catheter-based interventions are emerging as safe and effective alternatives for elderly patients (>75 years) and those with high surgical risk.
• The heart team approach is crucial for discussing interventional options in select CKD patients.

Conclusions:

• Chronic kidney disease significantly complicates the management and prognosis of valvular heart disease.
• Interventional cardiology provides a viable and less risky treatment avenue for specific patient cohorts with valvular heart disease and CKD.
• Shared decision-making within a heart team is essential for optimizing treatment strategies in this complex patient population.