Aortic Stenosis Progresses With Chronic Kidney Disease Stage

Aortic stenosis not only progresses in the dialysis population, but also in patients with nondialysis-dependent chronic kidney disease (CKD), a new study finds. The condition steadily progresses with declining estimated glomerular filtration rate (eGFR; in mL/min/1.73m²).

Among 647 patients with diagnosed aortic stenosis (peak aortic jet velocity [Vmax] of 2.5 m/s or more and a left ventricular ejection fraction of at least 50%), 261 patients (40%) had CKD. Over 2.9 years, the aortic valve area (AVA) significantly and progressively narrowed by -0.07, -0.08, -0.09, -0.10, and -0.10 cm²/year in patients with an eGFR of more than 60, 45-59, 30-44, 15-29, and less than 15, respectively, as assessed by echocardiography, Christophe Tribouilloy, MD, PhD, of Jules Verne University of Picardie in Amiens, France, and colleagues reported in Nephrology Dialysis and Transplantation.

An eGFR less than 45 was significantly associated with rapid progression of aortic stenosis as well as aortic valve placement or death compared with an eGFR greater than 60. Rapid progression of aortic stenosis (an aortic value area change above the median of -.07 cm²/year) in patients with an eGFR less than 45 was significantly associated with all-cause and cardiovascular mortality.

“Patients with kidney dysfunction should be closely monitored and those with rapid progression seriously considered for aortic valve replacement decision making,” according to Dr Tribouilloy’s team. “It is, therefore, important to include a nephrologist as an integral component of the heart–kidney team in the management, even for patients with mild to moderate CKD.”

Data on risk factors such as CKD-mineral and bone disorders, albuminuria, low-grade inflammation, and the etiology and duration of CKD were lacking, preventing further analyses.

This article originally appeared on Renal and Urology News