Abstract: TH-PO926
Aortic Valve Alterations in Dialysis-Initiating Patients: Patient Background and Prognosis
Session Information
- Geriatric Nephrology: Innovations and Insights
October 24, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Geriatric Nephrology
- 1300 Geriatric Nephrology
Authors
- Kitamura, Mineaki, Nagasaki Daigaku Byoin, Nagasaki, Japan
- Nishino, Tomoya, Nagasaki Daigaku Byoin, Nagasaki, Nagasaki, Japan
Background
Aortic stenosis (AS) is a critical complication in patients undergoing, and aortic valve calcification (AVC) is considered a culprit lesion. However, little is known regarding aortic valve changes in dialysis-initiating patients, as past studies focused on those undergoing maintenance dialysis. We aimed to elucidate the relationship between AVC, AS, and patient survival following dialysis initiation.
Methods
Patients initiating dialysis between 2016 and 2023 were included. Echocardiograms assessed aortic valve changes, defining AS with a maximum trans-aortic velocity > 2.0 m/s. Patients were categorized into AS, AVC only, and control groups and followed up until February 2024. Multivariable logistic regression and Cox regression were used.
Results
We included 289 patients (mean age: 71.8 ± 12.2 years, 65.3% male, HD: PD=275:14). Aortic valve changes were identified in 121 patients (42%), with 33 patients (11%) meeting AS criteria. The mean ages for the AS, AVC only, and control groups were 79.1±8.9, 75.9±9.2, and 68.3±12.9, respectively (P<0.001). Multivariable logistic regression identified age as the sole factor associated with aortic valve changes (P<0.001). During a median follow-up of 718 (interquartile range 307-1353) days, 88 patients died. The log-rank test revealed significantly worse outcomes in the AS group. Even adjusted multivariable Cox regression indicated that AS was an independent death risk factor post-dialysis initiation (HR: 1.95, 95% CI: 1.06−3.59, P=0.04). However, aortic valve changes (AS + AVC only) were not a significant death risk (HR: 1.51, 95% CI: 0.95−2.39, P=0.08).
Conclusion
AS and AVC are associated with age in patients initiating dialysis. However, AVC only was not a risk factor for death, suggesting that risk factors related to AS, such as serum phosphate levels, should be strictly controlled following dialysis initiation.
Kaplan–Meier curves for aortic stenosis (AS), aortic valve calcification (AVC), and Control groups.