Mean Transaortic Gradient is an Emerging Predictor of Chronic Kidney Disease in Elderly Patients.
Arterial hypertension (AH) is a major risk factor for chronic kidney disease (CKD). However, whether AH maintains this role in the development of CKD in elderly patients with aortic stenosis (AS) or whether transaortic gradient influences CKD remains unclear. Consecutive hospitalized patients were prospectively recruited to evaluate the relationship between AS and CKD. In all patients, transthoracic 2-dimensional echocardiography was performed to evaluate AS; renal function was evaluated using the Chronic Kidney Disease Epidemiology Collaboration formula. A total of 346 patients were included in the study (mean age: 79.5 ± 7.4 years): 104 had diabetes mellitus (DM), 298 had AH, and 59 (moderate: 52; severe: 7) showed AS. After multivariate analysis, age ( P <.01), DM ( P = .02), and mean transaortic gradient ( P = .03), but not AH, were independent predictors of CKD. Both in the presence (n = 59) or absence (n = 287) of AS, the estimated glomerular filtration rate did not differ in patients with (51 ± 24 mL/min/1.73 m2and 59 ± 25 mL/min/1.73 m2, respectively) and those without AH (50 ± 21 mL/min/1.73 m2and 65 ± 24 mL/min/1.73 m2, respectively). In the whole population, for each mm Hg of mean transaortic gradient, the risk of CKD increased by 2.5 times.
1 Department of Clinical and Experimental Medicine, Unit of Internal Medicine, Cannizzaro Hospital, University of Catania, Catania, Italy.
Ingrid
I
Platania
1 Department of Clinical and Experimental Medicine, Unit of Internal Medicine, Cannizzaro Hospital, University of Catania, Catania, Italy.
Valentina
V
Terranova
2 Department of Clinical and Experimental Medicine, Unit of Cardiology, Cannizzaro Hospital, University of Catania, Catania, Italy.
Salvatore Davide
SD
Tomasello
2 Department of Clinical and Experimental Medicine, Unit of Cardiology, Cannizzaro Hospital, University of Catania, Catania, Italy.
Marouane
M
Boukhris
1 Department of Clinical and Experimental Medicine, Unit of Internal Medicine, Cannizzaro Hospital, University of Catania, Catania, Italy.
Chiara
C
Cilia
1 Department of Clinical and Experimental Medicine, Unit of Internal Medicine, Cannizzaro Hospital, University of Catania, Catania, Italy.
Salvatore
S
Di Marca
1 Department of Clinical and Experimental Medicine, Unit of Internal Medicine, Cannizzaro Hospital, University of Catania, Catania, Italy.
Marcella
M
Pisano
1 Department of Clinical and Experimental Medicine, Unit of Internal Medicine, Cannizzaro Hospital, University of Catania, Catania, Italy.
Gianluca
G
Mastrosimone
1 Department of Clinical and Experimental Medicine, Unit of Internal Medicine, Cannizzaro Hospital, University of Catania, Catania, Italy.
Emanuela
E
Cataudella
1 Department of Clinical and Experimental Medicine, Unit of Internal Medicine, Cannizzaro Hospital, University of Catania, Catania, Italy.
Benedetta
B
Stancanelli
1 Department of Clinical and Experimental Medicine, Unit of Internal Medicine, Cannizzaro Hospital, University of Catania, Catania, Italy.
Lorenzo
L
Malatino
D000368:Aged; D001024:Aortic Valve Stenosis / Q000150:complications* / Q000000981:diagnostic imaging* / Q000503:physiopathology; D004452:Echocardiography; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000503:physiopathology; D008297:Male; D011237:Predictive Value of Tests; D011446:Prospective Studies; D051436:Renal Insufficiency, Chronic / Q000209:etiology*; D012307:Risk Factors
aortic valve stenosis; chronic kidney disease; diabetes mellitus; elderly; hypertension; mean transaortic gradient