{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T23:24:48Z","timestamp":1790897088899,"version":"4.1.0"},"reference-count":38,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"10","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2017,10,11]]},"abstract":"\n Background<\/jats:title>\n \n Chronic kidney disease (\n CKD<\/jats:styled-content>\n ) is an adverse prognostic marker for valve intervention patients; however, the prevalence and related outcomes of valvular heart disease in\n CKD<\/jats:styled-content>\n patients is unknown.\n <\/jats:p>\n <\/jats:sec>\n \n Methods and Results<\/jats:title>\n \n Included patients underwent echocardiography (1999\u20132013), had serum creatinine values within 6\u00a0months before index echocardiogram, and had no history of valve surgery. CKD was defined as diagnosis based on the\n International Classification of Diseases, Ninth Revision<\/jats:italic>\n or an estimated glomerular filtration rate <60\u00a0mL\/min per 1.73\u00a0m\n 2<\/jats:sup>\n . Qualitative assessment determined left heart stenotic and regurgitant valve lesions. Cox models assessed\n CKD<\/jats:styled-content>\n and aortic stenosis (\n AS<\/jats:styled-content>\n ) interaction for subsequent mortality; analyses were repeated for mitral regurgitation (\n MR<\/jats:styled-content>\n ). Among 78\u00a0059 patients, 23\u00a0727 (30%) had\n CKD<\/jats:styled-content>\n ; of these, 1326 were on hemodialysis. CKD patients were older; female; had a higher prevalence of hypertension, hyperlipidemia, diabetes, history of coronary artery bypass grafting\/percutaneous coronary intervention, atrial fibrillation, and heart failure \u2265mild AS; and \u2265mild MR (all\n P<\/jats:italic>\n <0.001). Five\u2010year survival estimates of mild, moderate, and severe\n AS<\/jats:styled-content>\n for\n CKD<\/jats:styled-content>\n patients were 40%, 34%, and 42%, respectively, and 69%, 54%, and 67% for non\u2010CKD patients. Five\u2010year survival estimates of mild, moderate, and severe\n MR<\/jats:styled-content>\n for\n CKD<\/jats:styled-content>\n patients were 51%, 38%, and 37%, respectively, and 75%, 66%, and 65% for non\u2010CKD patients. Significant interaction occurred among\n CKD<\/jats:styled-content>\n ,\n AS<\/jats:styled-content>\n \/\n MR<\/jats:styled-content>\n severity, and mortality in adjusted analyses; the\n CKD<\/jats:styled-content>\n hazard ratio increased from 1.8 (non\u2010\n AS<\/jats:styled-content>\n patients) to 2.0 (severe\n AS<\/jats:styled-content>\n ) and from 1.7 (non\u2010\n MR<\/jats:styled-content>\n patients) to 2.6 (severe\n MR<\/jats:styled-content>\n ).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n Prevalence of at least mild\n AS<\/jats:styled-content>\n and\n MR<\/jats:styled-content>\n is substantially higher and is associated with significantly lower survival among patients with versus without\n CKD<\/jats:styled-content>\n . There is significant interaction among\n CKD<\/jats:styled-content>\n ,\n AS<\/jats:styled-content>\n \/\n MR<\/jats:styled-content>\n severity, and mortality, with increasingly worse outcomes for\n CKD<\/jats:styled-content>\n patients with increasing\n AS<\/jats:styled-content>\n \/\n MR<\/jats:styled-content>\n severity.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.117.006044","type":"journal-article","created":{"date-parts":[[2017,10,11]],"date-time":"2017-10-11T20:10:20Z","timestamp":1507752620000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":113,"title":["Prevalence and Outcomes of Left\u2010Sided Valvular Heart Disease Associated With Chronic Kidney Disease"],"prefix":"10.1161","volume":"6","author":[{"given":"Zainab","family":"Samad","sequence":"first","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Duke University, Durham, NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph A.","family":"Sivak","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Duke University, Durham, NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Phelan","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute, Duke University, Durham, NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Phillip J.","family":"Schulte","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Mayo Clinic, Rochester, MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Uptal","family":"Patel","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute, Duke University, Durham, NC"},{"name":"Duke O'Brien Center for Kidney Diseases, Duke University, Durham, NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric J.","family":"Velazquez","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Duke University, Durham, NC"},{"name":"Duke Clinical Research Institute, Duke University, Durham, NC"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(87)91370-5"},{"key":"e_1_3_5_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(85)90549-5"},{"key":"e_1_3_5_4_2","doi-asserted-by":"publisher","DOI":"10.1186\/1476-7120-9-31"},{"key":"e_1_3_5_5_2","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfq596"},{"key":"e_1_3_5_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.atherosclerosis.2006.03.033"},{"key":"e_1_3_5_7_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2007.05.020"},{"key":"e_1_3_5_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2005.10.041"},{"key":"e_1_3_5_9_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1200384"},{"key":"e_1_3_5_10_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1202277"},{"key":"e_1_3_5_11_2","doi-asserted-by":"publisher","DOI":"10.1161\/cir.0000000000000031"},{"key":"e_1_3_5_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2011.08.067"},{"key":"e_1_3_5_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2014.09.049"},{"key":"e_1_3_5_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2015.08.004"},{"key":"e_1_3_5_15_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehv343"},{"key":"e_1_3_5_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2010.11.008"},{"key":"e_1_3_5_17_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.89.5.2015"},{"key":"e_1_3_5_18_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-150-9-200905050-00006"},{"key":"e_1_3_5_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2005.10.005"},{"key":"e_1_3_5_20_2","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a115470"},{"key":"e_1_3_5_21_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.106.678342"},{"key":"e_1_3_5_22_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa041365"},{"key":"e_1_3_5_23_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa041031"},{"key":"e_1_3_5_24_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.166.17.1884"},{"key":"e_1_3_5_25_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0118694"},{"key":"e_1_3_5_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0272-6386(96)90357-1"},{"key":"e_1_3_5_27_2","doi-asserted-by":"publisher","DOI":"10.1038\/ki.1989.192"},{"key":"e_1_3_5_28_2","first-page":"155","article-title":"Systolic and diastolic function in renal replacement therapy: a cross\u2010sectional study","volume":"19","author":"Virga G","year":"2006","unstructured":"Virga G, Stomaci B, Munaro A, Mastrosimone S, Cara M, Artuso E, Piovesana P. 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