Determinants of progression of aortic valve stenosis and outcome of adverse events in hemodialysis patients

Background: Hemodialysis (HD) is an important risk factor for progression of aortic valve stenosis (AS). However, there are varying degrees of disease progression among patients with AS on HD. The aim of this study was to find determinants of rapid progression of AS in patients on HD. Methods: We enrolled 30 patients with AS on HD with a mean follow-up period of 4 years. The peak pressure gradient (PPG) between the initial echocardiography and the last echocardiography at least 3 months interval (Delta PPG) was adopted as the indicator of AS progression. We divided the patients into two groups according to Delta PPG per year [rapid progression (Delta PPG >4.5 mmHg/year), slow progression (Delta PPG <4.5 mmHg/year)] and compared the clinical characteristics between the two groups. Results: Overall mean Delta PPG was 4.5 mmHg/year. Systolic blood pressure (SBP), serum calcium, and calcium-phosphate product were significantly higher in rapid progression group compared with slow progression group (p < 0.05). Conclusion: High systolic blood pressure, serum calcium, and calcium-phosphate product were associated with rapid progression of AS in patients on chronic HD. (C) 2011 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.