Chronic Kidney Disease Linked to Risk for Aortic Stenosis

A new study as for the first time shown an independent association between chronic kidney disease (CKD) and an increased risk for developing aortic stenosis.

The study, published this week in the Journal of the American College of Cardiology, included 1,121,875 participants from the Stockholm Creatinine Measurements (SCREAM) Project with no prior aortic stenosis. The researchers measured estimated glomerular filtration rate (eGFR) from serum creatinine, and then obtained data on incidence of aortic stenosis via diagnostic codes. They then used a multivariate Cox proportional hazards models to estimate the association between eGFR and aortic stenosis. The media age was 50 years, and median follow-up was 5.1 years.

What is the association between renal dysfunction and the risk for developing aortic stenosis? https://t.co/NQKJvm3rql #JACC @karolinskainst pic.twitter.com/nwsMRz5k71

— JACC Journals (@JACCJournals) January 23, 2019

The results indicated that 66,949 (6.0%) participants had CKD, and that 5,858 (0.5%) participants developed aortic stenosis during follow-up. Compared to eGFR >90, lower eGFR strata was associated with higher hazards of aortic stenosis:

• eGFR 60 to 90 mL/min/1.73 m²; IR: 1.88; HR=1.14; 95%CI: 1.05 to 1.25
• eGFR 45 to 59 mL/min/1.73 m²; IR: 4.61; HR=1.17; 95% CI: 1.05 to 1.30
• eGFR 30 to 44 mL/min/1.73 m²; IR: 6.62; HR=1.22; 95% CI: 1.07 to 1.39
• eGFR 30 mL/min/1.73 m²; IR: 8.27; HR=1.56; 95% CI: 1.29 to 1.87

Interesting, but not surprising association between #RenalDisease and #ValvularHeartDisease ( a different #cvVHD !)

Conclusions: #CKD, even in moderate to severe stages, is associated with an increased risk of #AS. #NephJC https://t.co/KODGUiGNKB

— John P Erwin III MD MBA MACC (#BigPoppy ) (@HeartOTXHeartMD) January 23, 2019

After learning about stenosis in #biom4180 I was curious about some causes of aortic stenosis. This is an interesting illustration demonstrating the the risk of developing aortic stenosis secondary to kidney dysfunction. #stenosis https://t.co/ViSC5p3gPA

— Emma Cain (@EmmaCardio) January 23, 2019

The magnitude of the relationship was only slightly attenuated after sensitivity analysis. Individuals with eGFR of 44 mL/min/1.73 m² or less were still at 20% increased risk for aortic stenosis.

https://twitter.com/ATRIUMRx/statuses/1088062085253218306

“Chronic kidney disease, even in moderate to severe stages, is associated with an increased risk of aortic stenosis,” the researchers wrote in their conclusion.

Source: JACC