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Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
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Prognostic Implications of Renal Dysfunction in Patients With Aortic Stenosis
E Mara Vollema1, Edgard A Prihadi2, Arnold C T Ng3
1Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands.
The American Journal of Cardiology
|January 27, 2020
Summary
Renal dysfunction significantly impacts aortic stenosis prognosis, with severely impaired kidney function independently linked to mortality. Aortic valve replacement improves survival, regardless of kidney function.
Area of Science:
- Cardiology
- Nephrology
- Clinical Medicine
Background:
- Aortic stenosis (AS) and renal dysfunction frequently coexist due to shared risk factors.
- The prognostic impact of renal dysfunction across different AS severities requires further elucidation.
Purpose of the Study:
- To evaluate the prognostic significance of renal dysfunction in a large cohort of patients with aortic sclerosis and varying grades of aortic stenosis.
- To assess the association of renal dysfunction with all-cause mortality and the need for aortic valve replacement (AVR).
Main Methods:
- A cohort of 1,178 patients with aortic sclerosis/AS, diagnosed via transthoracic echocardiography, was analyzed.
- Patients were stratified based on renal function using estimated glomerular filtration rate (eGFR).
- Outcomes included all-cause mortality and AVR, with a median follow-up of 95 months.
Main Results:
- Renal dysfunction (eGFR <60 ml/min/1.73 m²) was present in 37% of patients, more common in moderate-to-severe AS.
- Severely impaired renal function (eGFR <30 ml/min/1.73 m²) and AVR were independently associated with all-cause mortality, adjusting for AS severity.
- Aortic valve replacement was linked to improved survival, irrespective of renal function status.
Conclusions:
- Renal dysfunction is highly prevalent in patients with aortic stenosis.
- Severely impaired renal function is an independent predictor of mortality in AS patients, even after accounting for AS severity and AVR.
- Aortic valve replacement offers survival benefits for AS patients, independent of their renal function.
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