Background
Materials and methods
Study population
Definition of aortic stenosis and aortic valve calcification
Statistical analysis
Ethics approval and consent to participate
Results
Baseline patient characteristics
non-AS group | G1 | p value | G2 | p value | |
---|---|---|---|---|---|
Basic Characteristics | |||||
Male, % | 67.0 | 63.6 | 0.13 | 59.6 | 0.04 |
Age, years | 68 (59–75) | 75 (68–82) | < 0.001 | 77 (70–83) | < 0.001 |
Duration of dialysis, years | 6.2 (3.1–12.4) | 8.0 (3.8–15.1) | < 0.001 | 7.4 (4.0–14.8) | 0.005 |
Primary Disease | |||||
Nephrosclerosis, % | 11.9 | 17.3 | 0.001 | 16.6 | 0.07 |
Diabetic nephropathy, % | 39.8 | 29.5 | < 0.001 | 31.6 | 0.03 |
Chronic glomerulonephritis, % | 19.5 | 23.8 | 0.03 | 23.8 | 0.16 |
Comorbidity | |||||
Diabetes mellitus, % | 46.0 | 36.0 | < 0.001 | 39.9 | 0.11 |
Admission due to HF < 1 year, % | 2.0 | 5.2 | < 0.001 | 8.3 | < 0.001 |
Percutaneous coronary intervention, % | 10.8 | 15.5 | 0.003 | 16.1 | 0.03 |
Coronary artery bypass grafting, % | 4.7 | 6.7 | 0.07 | 9.3 | 0.01 |
Aortic disease, % | 4.8 | 10.8 | < 0.001 | 14.0 | < 0.001 |
Usage rate of medicine related to MBD | |||||
Vitamin D receptor activators, % | 81.3 | 79.6 | 0.40 | 78.2 | 0.29 |
Calcimimetics, % | 34.9 | 35.5 | 0.80 | 38.3 | 0.35 |
Phosphate binders, % | 84.7 | 78.6 | < 0.001 | 77.2 | 0.01 |
Blood Test | |||||
Corrected Calcium, mg/dl | 9.1 ± 0.6 | 9.1 ± 0.6 | 0.16 | 9.1 ± 0.7 | 0.55 |
Phosphorus, mg/dl | 5.3 ± 1.3 | 5.2 ± 1.2 | 0.76 | 5.2 ± 1.2 | 0.59 |
Intact PTH, pg/ml | 132 (80–193) | 122 (76–185) | 0.05 | 118 (76–162) | 0.04 |
Albumin, g/dl | 3.6 ± 0.4 | 3.5 ± 0.4 | < 0.001 | 3.4 ± 0.37 | < 0.001 |
C-reactive protein, mg/dl | 0.12 (0.05–0.37) | 0.12 (0.06–0.43) | 0.15 | 0.11 (0.06–0.55) | 0.15 |
Hemoglobin, g/dl | 11.1 ± 1.1 | 10.9 ± 1.2 | < 0.001 | 10.8 ± 1.1 | 0.002 |
Chest radiography | |||||
Cardiothoracic ratio, % | 50.2 ± 5.1 | 52.2 ± 5.0 | < 0.001 | 53.0 ± 5.0 | < 0.001 |
Aortic calcification, % | 57.0 | 70.4 | < 0.001 | 73.3 | < 0.001 |
Electrocardiogram | |||||
Atrial fibrillation, % | 5.7 | 9.6 | 0.002 | 12.0 | 0.002 |
Heart rate, /min | 74 ± 13 | 74 ± 13 | 0.91 | 75 ± 13 | 0.63 |
Transthoracic Echocardiography | |||||
Left atrial diameter, mm | 36.6 ± 6.5 | 38.5 ± 6.4 | < 0.001 | 39.1 ± 5.9 | < 0.001 |
LVDd, mm | 46.9 ± 6.8 | 46.9 ± 6.1 | 0.63 | 46.2 ± 6.4 | 0.26 |
LVDs, mm | 30.6 ± 6.4 | 30.5 ± 6.0 | 0.96 | 30.1 ± 6.6 | 0.17 |
Left ventricular ejection fraction, % | 63.4 ± 9.7 | 63.5 ± 10.0 | 0.52 | 63.5 ± 11.3 | 0.37 |
Aortic valve calcification, % | 53.3 | 80.7 | < 0.001 | 83.8 | < 0.001 |
Mean pressure gradient, mmHg | 5.1 ± 2.7 | 15.5 ± 9.6 | < 0.001 | 23.3 ± 11.8 | < 0.001 |
Aortic valve area, cm2 | 2.51 ± 0.77 | 1.56 ± 0.62 | < 0.001 | 1.08 ± 0.46 | < 0.001 |
Velocity max, m/s | 1.43 ± 0.28 | 2.52 ± 0.62 | < 0.001 | 2.96 ± 0.87 | < 0.001 |
Multivariate logistic regression analysis for aortic stenosis
G1 | G2 | |||
---|---|---|---|---|
aOR (95% CI) | p value | aOR (95% CI) | p value | |
Male | 1.02 (0.81–1.29) | 0.86 | 0.94 (0.65–1.37) | 0.75 |
Age (per 10 years) | 1.93 (1.71–2.19) | < 0.001 | 2.51 (2.02–3.12) | < 0.001 |
Duration of dialysis (per 10 years) | 1.41 (1.21–1.64) | < 0.001 | 1.35 (1.06–1.71) | 0.01 |
Nephrosclerosis as the primary contributor to CKD | 0.94 (0.67–1.32) | 0.72 | 0.88 (0.52–1.50) | 0.65 |
Diabetes mellitus comorbidity | 0.74 (0.58–0.95) | 0.02 | 0.95 (0.64–1.40) | 0.79 |
Calcimimetic use | 1.16 (0.91–1.48) | 0.24 | 1.59 (1.07–2.34) | 0.02 |
VDRA administration | 0.94 (0.70–1.25) | 0.66 | 0.91 (0.58–1.44) | 0.69 |
Phosphate binder use | 0.87 (0.65–1.17) | 0.35 | 0.86 (0.55–1.35) | 0.52 |
Corrected Calcium (per 1 mg/dl) | 1.27 (1.04–1.54) | 0.02 | 1.17 (0.86–1.59) | 0.31 |
Phosphorus (per 1 mg/dl) | 1.16 (1.06–1.28) | 0.001 | 1.24 (1.07–1.44) | 0.005 |
Intact PTH (per 10 pg/ml) | 1.00 (0.99–1.01) | 0.41 | 1.00 (0.98–1.02) | 0.91 |
Albumin (per 1 g/dl) | 1.51 (1.05–2.17) | 0.03 | 1.04 (0.58–1.84) | 0.91 |
C-reactive protein (per 1 mg/dl) | 0.98 (0.89–1.08) | 0.67 | 1.02 (0.91–1.14) | 0.77 |
Hemoglobin (per 1 g/dl) | 0.85 (0.76–0.95) | 0.003 | 0.86 (0.72–1.03) | 0.10 |
Characteristics of patients with aortic valve calcification
Aortic valve calcification | ||
---|---|---|
OR (95% CI) | p value | |
Male | 0.93 (0.75–1.16) | 0.53 |
Age (per 10 years) | 1.70 (1.54–1.88) | < 0.001 |
Duration of dialysis (per 10 years) | 1.42 (1.22–1.64) | < 0.001 |
Nephrosclerosis as the primary contributor to CKD | 0.88 (0.69–1.06) | 0.43 |
Diabetes mellitus comorbidity | 1.53 (1.23–1.90) | < 0.001 |
Calcimimetic use | 0.86 (0.69–1.06) | 0.16 |
VDRA administration | 0.70 (0.54–0.91) | 0.007 |
Phosphate binder use | 0.92 (0.69–1.23) | 0.57 |
Corrected Calcium (per 1 mg/dl) | 1.30 (1.09–1.54) | 0.004 |
Phosphorus (per 1 mg/dl) | 1.03 (0.95–1.12) | 0.46 |
Intact PTH (per 10 pg/ml) | 1.00 (0.99–1.01) | 0.56 |
Albumin (per 1 g/dl) | 1.19 (0.87–1.63) | 0.28 |
C-reactive protein (per 1 mg/dl) | 0.98 (0.90–1.07) | 0.65 |
Hemoglobin (per 1 g/dl) | 0.89 (0.81–0.98) | 0.02 |
With aortic valve calcification | Without aortic valve calcification | I value | |
---|---|---|---|
Velocity max, m/s | 1.78 ± 0.64 | 1.51 ± 0.50 | < 0.001 |
Mean pressure gradient, mmHg | 8.3 ± 7.9 | 6.3 ± 4.8 | < 0.001 |
Aortic valve area, cm2 | 2.19 ± 0.79 | 2.50 ± 0.90 | < 0.001 |