Accelerated progression and morbidity in patients with aortic stenosis on chronic dialysis

Abstract

Background: Progression of aortic stenosis (AS) influences the prognosis in chronic dialysis (CD) patients, but there have been few studies in Japanese patient populations. Methods and Results: The progression of AS was examined in 16 CD patients (68±10 years) and 82 non-dialysis patients (73±11 years). The mean follow-up was 32 and 40 months, respectively. The calcium - phosphate product was increased in CD patients (49±14 mg/dl vs 30±5 mg/dl; p<0.0001). At entry, the peak transaortic gradient detected by Doppler echocardiography was lower in CD patients (42±12mmHg vs 57±22mmHg; p<0.05). At follow-up, there was no difference between the 2 groups in that value (69±31mmHg vs 71±27mmHg). Decreasing rate of calculated aortic valvular area was increased in CD patients (0.14±0.13cm2/year vs 0.06±0.09cm2/year; p<0.05) and the calcification of the aortic valve was more severe at follow up in CD patients. The mortality was higher in CD patients (75 vs 28%; p<0.001). Conclusions: AS appeared to progress rapidly in CD patients and therefore early aortic valve replacement may be necessary.