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BMC Nephrology

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Open Access 01-12-2022 | Transthoracic Echocardiography | Research

Factors associated with aortic valve stenosis in Japanese patients with end-stage kidney disease

Authors: Yuji Sasakawa, Naoki Okamoto, Maya Fujii, Jyoichiro Kato, Yukio Yuzawa, Daijo Inaguma

Published in: BMC Nephrology | Issue 1/2022

Abstract

Background

Aortic valve stenosis (AS) has a high prevalence and poor prognosis in patients who receive maintenance dialysis. However, few large-scale observational studies in Japan have investigated patients with AS who underwent dialysis. In this study, we investigated the prevalence and factors associated with AS in Japanese patients who underwent dialysis.

Methods

In this cross-sectional analysis, we enrolled patients who underwent dialysis and transthoracic echocardiography between July 1, 2017 and June 30, 2018. Patients with a maximum aortic jet velocity (Vmax) ≥ 2.0 m/s, pressure gradient (PG) between the left ventricle and ascending aorta (mean PG) ≥ 20 mmHg, or aortic valve area (AVA) ≤ 1.0 cm² were categorized into the AS group (G1). Patients with Vmax ≥ 3.0 m/s, mean PG ≥ 20 mmHg, or AVA ≤ 1.0 cm² were categorized into the moderate and severe AS groups (G2). We performed multivariate logistic regression analysis and compared G1 and G2 with the non-AS group to determine the risk factors for AS. We also investigated the risk factors for aortic valve calcification, which is a pre-stage for AS.

Results

Of the 2,786 patients investigated, 555 (20.0%) and 193 (6.9%) were categorized into G1 and G2, respectively. Multivariate logistic regression analysis revealed that age, long-term dialysis, and elevated serum phosphorus levels were associated with AS in both the groups (p < 0.05). These factors were converted into ordinal categories, and a multivariate logistic regression analysis was performed. Patients with serum phosphorus levels measuring 5.0–5.9 mg/dL and > 6.0 mg/dL showed a higher risk of AS than those with serum phosphorus levels measuring < 4.0 mg/dL (odds ratio 2.24, p = 0.01 and odds ratio 2.66, p = 0.005, respectively). Aortic valve calcification was associated with age, long-term dialysis, diabetes mellitus, administration of vitamin D receptor activators, elevated serum calcium levels, and anemia (p < 0.05 for all).

Conclusions

Patients on dialysis showed a high prevalence of AS, which was associated with age, long-term dialysis, and elevated serum phosphorus levels.

Trial registration

UMIN000026756, registered on March 29, 2017.

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Title: Factors associated with aortic valve stenosis in Japanese patients with end-stage kidney disease
Authors: Yuji Sasakawa
Naoki Okamoto
Maya Fujii
Jyoichiro Kato
Yukio Yuzawa
Daijo Inaguma
Publication date: 01-12-2022
Publisher: BioMed Central
Keywords: Transthoracic Echocardiography
Aortic Valve Stenosis
Published in: BMC Nephrology / Issue 1/2022
Electronic ISSN: 1471-2369
DOI: https://doi.org/10.1186/s12882-022-02758-y

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Factors associated with aortic valve stenosis in Japanese patients with end-stage kidney disease

Abstract

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Results

Conclusions

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