Aortic stenosis linked to chronic kidney disease
Patients with moderate to severe chronic kidney disease may be at increased risk of developing aortic stenosis, according to results from the Swedish SCREAM project.
Previous studies have shown that patients undergoing dialysis have an increased prevalence of aortic stenosis, but evidence linking chronic kidney disease with the risk of aortic stenosis has been inconsistent.
This new finding could prompt doctors to intensify cardioprevention strategies in these patients, such as encouraging greater lifestyle modification, prescribing statins and closer monitoring for cardiovascular risk factors, says lead author Dr Georgios Vavilis from the Karolinska Institutein in Stockholm.
Dr Vavilis and colleagues used data from more than 1.1 million participants in the Stockholm CREAtinine Measurement (SCREAM) project to investigate whether kidney dysfunction was associated with the incidence of aortic stenosis.
During a median 5.1 years of follow-up, the crude incidence of aortic stenosis increased linearly as the estimated eGFR decreased.
The results, published in the Journal of the American College of Cardiology, showed the incidence was 0.34 per 1000 person-years in participants with an eGFR greater than 90mL/min/1.73 m2.
This increased to 8.27 per 1000 person-years in participants with an eGFR under 30mL/min/1.73 m2.
This trend persisted in each age category over 50.
After adjustment for other factors, the risk of aortic stenosis was 14% higher among individuals with an eGFR 60-90mL/min/1.73 m2 compared with individuals with a normal eGFR (more than 90mL/min/1.73 m2).
The risk was also 56% higher among individuals with an eGFR less than 30mL/min/1.73 m2 compared with normal-range individuals.
"This is an observational study, which can only describe associations, not causation," Dr Vavilis said.
"Studies should follow that decipher underlying mechanisms, for they may also serve as therapeutic targets for aortic stenosis prevention."