Severe aortic stenosis and chronic kidney disease: Outcomes and impact of aortic valve replacement

Aims To analyze the relationship between chronic kidney disease(CKD) stages and all-cause and cardiovascular mortality and evaluate the effect of aortic-valve replacement(AVR) versus conservative management according to kidney function in patients with severe aortic stenosis(AS). Methods and results This analysis included 4119 patients with severe AS. The population was divided into four groups according to the baseline estimated glomerular filtration rate: no CKD, mild CKD, moderate CKD, and severe CKD. The five-year survival rate was 71 ± 1% for patients without CKD, 62 ± 2% for those with mild CKD, 54 ± 3% for those with moderate CKD, and 34 ± 4% for those with severe CKD (P  Fig. 1 ). Conclusion In severe AS, moderate and severe CKD are associated with increased mortality and decreased referral to AVR. AVR markedly reduces all-cause and cardiovascular mortality, regardless of the CKD stage. Therefore, CKD should not discourage physicians from considering AVR.