Torigoe Miki, Kitamura Mineaki, Yamaguchi Kosei, Uchino Takumi, Torigoe Kenta, Harada Takashi, Funakoshi Satoshi, Yamamoto Kazuko, Maemura Koji, Eishi Kiyoyuki, Mukae Hiroshi, Nishino Tomoya
Department of Nephrology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8523, Japan.
Nagasaki Renal Center, Nagasaki 852-8102, Japan.
J Clin Med. 2021 Sep 25;10(19):4385. doi: 10.3390/jcm10194385.
We aimed to investigate the factors associated with the development of aortic stenosis (AS) in patients undergoing hemodialysis (HD), and to elucidate the prognosis of HD patients with AS. Patients on HD that had also undergone echocardiography at Nagasaki Renal Center between July 2011 and June 2012 were included. Patients with AS at the time of inclusion were excluded. The diagnosis of AS was based on an annual routine or additional echocardiography. The patients were followed up until June 2021. The association between patient background and AS was also evaluated. Of the 302 patients (mean age, 67.4 ± 13.3 years; male, 58%; median dialysis history, 4.7 years), 60 developed AS and 10 underwent aortic valve replacement. A Cox proportional hazards model revealed that age (hazard ratio (HR), 1.07; 95% confidential interval (CI), 1.04-1.10; < 0.001) and serum phosphate levels (HR, 1.40; 95%CI, 1.16-1.67, < 0.001) were independent risk factors for developing AS. Incidentally, there was no significant mortality difference between patients with AS and those without ( = 0.53). Serum phosphate levels are a risk factor for developing AS and should be controlled. Annual echocardiography may contribute to the early detection of AS and improves the prognosis of patients undergoing HD.
我们旨在研究血液透析（HD）患者主动脉瓣狭窄（AS）发生发展的相关因素，并阐明AS的HD患者的预后情况。纳入了2011年7月至2012年6月期间在长崎肾脏中心接受过超声心动图检查的HD患者。入组时患有AS的患者被排除。AS的诊断基于年度常规或额外的超声心动图检查。对患者进行随访至2021年6月。还评估了患者背景与AS之间的关联。在302例患者中（平均年龄67.4±13.3岁；男性占58%；透析史中位数为4.7年），60例发生了AS，10例接受了主动脉瓣置换术。Cox比例风险模型显示，年龄（风险比（HR）为1.07；95%置信区间（CI）为1.04 - 1.10；P<0.001）和血清磷酸盐水平（HR为1.40；95%CI为1.16 - 1.67，P<0.001）是发生AS的独立危险因素。顺便提一下，有AS的患者和无AS的患者之间死亡率无显著差异（P = 0.53）。血清磷酸盐水平是发生AS的一个危险因素，应加以控制。年度超声心动图检查可能有助于AS的早期检测，并改善HD患者的预后。
