Prospective evaluation of aortic stenosis in end-stage kidney disease: a more fulminant process?

نویسندگان

  • Dominica Zentner
  • David Hunt
  • William Chan
  • Federica Barzi
  • Leeanne Grigg
  • Vlado Perkovic
چکیده

BACKGROUND We have previously demonstrated an increased rate of progression of aortic stenosis (AS) in patients with end-stage kidney disease (CKD 5D) compared to controls. We sought to follow prospectively a CKD 5D cohort with AS and determine major event-free survival. Follow-up was terminated once all CKD 5D subjects had undergone aortic valve replacement (AVR) or died. Our aim was to determine whether the increased rate of progression resulted in shorter major event-free (AVR or death) survival as compared to controls. METHODS We re-matched our original CKD 5D cohort (n = 27) to a control cohort (n = 27) based on aortic valve area (AVA) at completion of the prior study. This was done as CKD 5D and AVA were the only statistically significant variables with respect to rate of progression. RESULTS All the CKD 5D patients (100%) underwent surgery or died during the follow-up period. In contrast, 17 (63%) of the controls underwent surgery or died. Of the remaining 10 controls, nine remain alive and free of AVR and one was lost to follow-up. CONCLUSION The controls displayed greater major event-free survival (P = 0.001), suggesting a need to consider patients with CKD 5D and AS for early AVR once echocardiographic evidence of moderate to severe AS is present, regardless of symptoms.

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Aortic Balloon Valvuloplasty Prior to Orthotopic Liver Transplantation: A Novel Approach to Aortic Stenosis and End-Stage Liver Disease

The combination of severe aortic stenosis and end-stage liver disease increases the morbidity and mortality of surgical aortic valve replacement or orthotopic liver transplantation resulting in a prohibitive operative risk. We propose a staged approach of balloon aortic valvuloplasty prior to orthotopic liver transplantation as a bridge to definitive aortic valve replacement. Between 2010 and 2...

متن کامل

Experimentally-Induced Metabolic Acidosis Does not Alter Aortic Fatty Streak Formation in High-Cholesterol Fed Rabbits

Objective(s)Cardiovascular disease causes a major clinical problem in patients with end stage renal disease. Since metabolic acidosis is very common in patients with end stage renal disease, we aimed to investigate the effect of experimentally-induced metabolic acidosis on serum lipid profile and aortic fatty streak (FS) formation in normal and high-cholesterol fed rabbits.Materials and Methods...

متن کامل

SONOGRAPHIC EVALUATION OF AORTOILIAC ATHEROSCLEROSIS IN CHRONIC RENAL FAILURE PATIENTS OLDER THAN 45 YEARS: A CASE-CONTROL STUDY

Background & Aims: Patients with chronic kidney disease (CKD) encounter many complications and morbidities. One of these major complications is accelerated atherosclerosis which is believed to be multifactorial in CKD and dialysis patients. Ultrasonographic evaluation of arteries has been proposed as an accurate and non-invasive method in assessing the process of atherosclerosis. Atheroscleroti...

متن کامل

Lactulose efficacy in reduction of nitrogen products, blood potassium and fluid overload in patients with end-stage renal failure.

Abstract Introduction. Chronic kidney disease (CKD) is a major public health problem that often goes unrecognized until late-stage disease. Patients with chronic kidney disease (CKD) face with uremic toxins and hyperkalemia. Also fluid overload in CKD patients is associated with rapid decline in kidney function. Lactulose is a hyper osmotic agent and as a prebiotic could reduce serum urea and p...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

عنوان ژورنال:
  • Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association

دوره 26 5  شماره 

صفحات  -

تاریخ انتشار 2011