Aortic stenosis is a risk factor for all-cause mortality in patients on dialysis: A multicenter prospective cohort analysis

Daijo Inaguma; Yuji Sasakawa; Noriko Suzuki; Eri Ito; Kazuo Takahashi; Hiroki Hayashi; Shigehisa Koide; Midori Hasegawa; Yukio Yuzawa; Hirofumi Tamai; Shuichi Tsutsui; Takuya Ueda; Yukio Narita; Fumio Sofue; Yasuhiro Hirano; Masahiro Motokawa; Masamiki Miwa; Nobuo Suzuki; Shinichiro Kojima; Hisato Takatsu; Toshiyuki Akahori; Kazutaka Murakami; Yasunobu Shimano; Takashi Miyazaki; Kaori Baba; Yoshiyasu Iida; Haruki Endo; Ryuichi Furuya; Isao Aoyama; Yasuhide Mizutani; Hachiro Seno; Takashi Nagaya; Hirotake Kasuga; Satoshi Sugiyama; Kanako Kojima; Kazuhiro Fujisawa; Tomohiko Naruse; Osamu Ishida; Hideto Oishi; Akira Ono; Hideaki Shimizu; Kiyonari Kato; Isao Ito; Shinji Yasutomi; Chikao Yamazaki; Kaoru Yasuda; Teppei Matsuoka; Yoshinari Tsuruta; Masao Mizuno; Masataka Ono; Masahiro Okada; Akiko Tanoue; Takaaki Obayashi; Itsuo Yokoyama; Hiroko Kushimoto; Hiroshi Hasegawa; Masao Kawasumi; Atsushi Nomura; Yasuhiro Sakurauchi; Mitsuru Yamashita; Hiroaki Asada; Keiji Ohara; Sukenari Koyabu; Masashi Tada; Fumihiko Sato; Satoshi Yamaguchi; Hiroshi Ogawa; Yoshihiro Ota; Yoshihiro Matsumoto; Satoki Otsuka; Yasushi Namii; Yasushi Kasai; Nobuo Kato; Makoto Nakayama; Haruo Sato; Shinichiro Inaba; Masaya Shibata; Hiroshi Yamashita; Junichiro Yamamoto; Makoto Yamaguchi

doi:10.1186/s12882-018-0877-6

Aortic stenosis is a risk factor for all-cause mortality in patients on dialysis: A multicenter prospective cohort analysis

Daijo Inaguma, Yuji Sasakawa, Noriko Suzuki, Eri Ito, Kazuo Takahashi, Hiroki Hayashi, Shigehisa Koide, Midori Hasegawa, Yukio Yuzawa, Hirofumi Tamai, Shuichi Tsutsui, Takuya Ueda, Yukio Narita, Fumio Sofue, Yasuhiro Hirano, Masahiro Motokawa, Masamiki Miwa, Nobuo Suzuki, Shinichiro Kojima, Hisato TakatsuToshiyuki Akahori, Kazutaka Murakami, Yasunobu Shimano, Takashi Miyazaki, Kaori Baba, Yoshiyasu Iida, Haruki Endo, Ryuichi Furuya, Isao Aoyama, Yasuhide Mizutani, Hachiro Seno, Takashi Nagaya, Hirotake Kasuga, Satoshi Sugiyama, Kanako Kojima, Kazuhiro Fujisawa, Tomohiko Naruse, Osamu Ishida, Hideto Oishi, Akira Ono, Hideaki Shimizu, Kiyonari Kato, Isao Ito, Shinji Yasutomi, Chikao Yamazaki, Kaoru Yasuda, Teppei Matsuoka, Yoshinari Tsuruta, Masao Mizuno, Masataka Ono, Masahiro Okada, Akiko Tanoue, Takaaki Obayashi, Itsuo Yokoyama, Hiroko Kushimoto, Hiroshi Hasegawa, Masao Kawasumi, Atsushi Nomura, Yasuhiro Sakurauchi, Mitsuru Yamashita, Hiroaki Asada, Keiji Ohara, Sukenari Koyabu, Masashi Tada, Fumihiko Sato, Satoshi Yamaguchi, Hiroshi Ogawa, Yoshihiro Ota, Yoshihiro Matsumoto, Satoki Otsuka, Yasushi Namii, Yasushi Kasai, Nobuo Kato, Makoto Nakayama, Haruo Sato, Shinichiro Inaba, Masaya Shibata, Hiroshi Yamashita, Junichiro Yamamoto, Makoto Yamaguchi

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Abstract

Background: Aortic stenosis (AS) is common in patients on dialysis as well as in the general population. AS leads to difficulty with dialysis therapy because of unstable conditions such as intradialytic hypotension due to low cardiac output. However, the precise morbidity rates and risk factors of AS in patients on dialysis are unknown. Moreover, there are no large-scale observational studies regarding the association between AS in patients on dialysis and mortality. Therefore, we will investigate whether morbidity of AS in patients on dialysis is associated with mortality. Methods: This is a multicenter prospective cohort analysis in the Tokai region of Japan. The 75 participating centers in this study will enroll approximately 2400 patients during 12 months, with or without AS. We started enrollment in July 2017 and will follow patents until June 2023. Transthoracic echocardiography will be performed to evaluate aortic valve. Parameters used for evaluation of aortic valve are mean pressure gradient between left ventricle and ascending aorta, aortic valve area, and maximum aortic jet velocity. We will diagnose AS using the criteria based on the 2014 American Heart Association/American College of Cardiology Guideline. We will also perform transthoracic echocardiography at 12, 24, 36, 48, and 60 months. Survival prognosis and CV events will be determined at the end of June 2019, 2020, 2021, 2022, and 2023. Development of AS will be also evaluated as new onset or annual change in AS parameters. We will classify patients based on the presence or absence of AS and the stages of AS and will compare outcomes. Study outcomes will include the following: 1) all-cause mortality rates; 2) incidence of cardiovascular (CV) events; 3) CV-related mortality rates; 4) infection-related mortality rates; 5) new onset or development of AS. Discussion: We will consider the following hypotheses in this study, among others: The prevalence of AS is higher in dialysis patients; new onset and development of AS are associated with factors that are specific for dialysis, such as hyperphosphatemia, hyperparathyroidism, and medication; and outcomes in AS patients are poorer than in patients without AS at baseline. Trial registration: UMIN000026756, Registered March 29 2017.

Original language	English
Article number	80
Journal	BMC Nephrology
Volume	19
Issue number	1
DOIs	https://doi.org/10.1186/s12882-018-0877-6
Publication status	Published - 03-04-2018

All Science Journal Classification (ASJC) codes

Nephrology

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10.1186/s12882-018-0877-6

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Inaguma, D., Sasakawa, Y., Suzuki, N., Ito, E., Takahashi, K., Hayashi, H., Koide, S., Hasegawa, M., Yuzawa, Y., Tamai, H., Tsutsui, S., Ueda, T., Narita, Y., Sofue, F., Hirano, Y., Motokawa, M., Miwa, M., Suzuki, N., Kojima, S., ... Yamaguchi, M. (2018). Aortic stenosis is a risk factor for all-cause mortality in patients on dialysis: A multicenter prospective cohort analysis. BMC Nephrology, 19(1), Article 80. https://doi.org/10.1186/s12882-018-0877-6

@article{87569a0f9a1d4578a417a7d6132ca0f9,

title = "Aortic stenosis is a risk factor for all-cause mortality in patients on dialysis: A multicenter prospective cohort analysis",

abstract = "Background: Aortic stenosis (AS) is common in patients on dialysis as well as in the general population. AS leads to difficulty with dialysis therapy because of unstable conditions such as intradialytic hypotension due to low cardiac output. However, the precise morbidity rates and risk factors of AS in patients on dialysis are unknown. Moreover, there are no large-scale observational studies regarding the association between AS in patients on dialysis and mortality. Therefore, we will investigate whether morbidity of AS in patients on dialysis is associated with mortality. Methods: This is a multicenter prospective cohort analysis in the Tokai region of Japan. The 75 participating centers in this study will enroll approximately 2400 patients during 12 months, with or without AS. We started enrollment in July 2017 and will follow patents until June 2023. Transthoracic echocardiography will be performed to evaluate aortic valve. Parameters used for evaluation of aortic valve are mean pressure gradient between left ventricle and ascending aorta, aortic valve area, and maximum aortic jet velocity. We will diagnose AS using the criteria based on the 2014 American Heart Association/American College of Cardiology Guideline. We will also perform transthoracic echocardiography at 12, 24, 36, 48, and 60 months. Survival prognosis and CV events will be determined at the end of June 2019, 2020, 2021, 2022, and 2023. Development of AS will be also evaluated as new onset or annual change in AS parameters. We will classify patients based on the presence or absence of AS and the stages of AS and will compare outcomes. Study outcomes will include the following: 1) all-cause mortality rates; 2) incidence of cardiovascular (CV) events; 3) CV-related mortality rates; 4) infection-related mortality rates; 5) new onset or development of AS. Discussion: We will consider the following hypotheses in this study, among others: The prevalence of AS is higher in dialysis patients; new onset and development of AS are associated with factors that are specific for dialysis, such as hyperphosphatemia, hyperparathyroidism, and medication; and outcomes in AS patients are poorer than in patients without AS at baseline. Trial registration: UMIN000026756, Registered March 29 2017.",

author = "Daijo Inaguma and Yuji Sasakawa and Noriko Suzuki and Eri Ito and Kazuo Takahashi and Hiroki Hayashi and Shigehisa Koide and Midori Hasegawa and Yukio Yuzawa and Hirofumi Tamai and Shuichi Tsutsui and Takuya Ueda and Yukio Narita and Fumio Sofue and Yasuhiro Hirano and Masahiro Motokawa and Masamiki Miwa and Nobuo Suzuki and Shinichiro Kojima and Hisato Takatsu and Toshiyuki Akahori and Kazutaka Murakami and Yasunobu Shimano and Takashi Miyazaki and Kaori Baba and Yoshiyasu Iida and Haruki Endo and Ryuichi Furuya and Isao Aoyama and Yasuhide Mizutani and Hachiro Seno and Takashi Nagaya and Hirotake Kasuga and Satoshi Sugiyama and Kanako Kojima and Kazuhiro Fujisawa and Tomohiko Naruse and Osamu Ishida and Hideto Oishi and Akira Ono and Hideaki Shimizu and Kiyonari Kato and Isao Ito and Shinji Yasutomi and Chikao Yamazaki and Kaoru Yasuda and Teppei Matsuoka and Yoshinari Tsuruta and Masao Mizuno and Masataka Ono and Masahiro Okada and Akiko Tanoue and Takaaki Obayashi and Itsuo Yokoyama and Hiroko Kushimoto and Hiroshi Hasegawa and Masao Kawasumi and Atsushi Nomura and Yasuhiro Sakurauchi and Mitsuru Yamashita and Hiroaki Asada and Keiji Ohara and Sukenari Koyabu and Masashi Tada and Fumihiko Sato and Satoshi Yamaguchi and Hiroshi Ogawa and Yoshihiro Ota and Yoshihiro Matsumoto and Satoki Otsuka and Yasushi Namii and Yasushi Kasai and Nobuo Kato and Makoto Nakayama and Haruo Sato and Shinichiro Inaba and Masaya Shibata and Hiroshi Yamashita and Junichiro Yamamoto and Makoto Yamaguchi",

note = "Publisher Copyright: {\textcopyright} 2018 The Author(s).",

year = "2018",

month = apr,

day = "3",

doi = "10.1186/s12882-018-0877-6",

language = "English",

volume = "19",

journal = "BMC Nephrology",

issn = "1471-2369",

publisher = "BioMed Central",

number = "1",

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Inaguma, D, Sasakawa, Y, Suzuki, N, Ito, E, Takahashi, K , Hayashi, H , Koide, S , Hasegawa, M , Yuzawa, Y, Tamai, H, Tsutsui, S, Ueda, T, Narita, Y, Sofue, F, Hirano, Y, Motokawa, M, Miwa, M, Suzuki, N, Kojima, S, Takatsu, H, Akahori, T, Murakami, K, Shimano, Y, Miyazaki, T, Baba, K, Iida, Y, Endo, H, Furuya, R, Aoyama, I, Mizutani, Y, Seno, H, Nagaya, T, Kasuga, H, Sugiyama, S, Kojima, K, Fujisawa, K, Naruse, T, Ishida, O, Oishi, H, Ono, A, Shimizu, H, Kato, K, Ito, I, Yasutomi, S, Yamazaki, C, Yasuda, K, Matsuoka, T, Tsuruta, Y, Mizuno, M, Ono, M, Okada, M, Tanoue, A, Obayashi, T, Yokoyama, I, Kushimoto, H, Hasegawa, H, Kawasumi, M, Nomura, A, Sakurauchi, Y, Yamashita, M, Asada, H, Ohara, K, Koyabu, S, Tada, M, Sato, F, Yamaguchi, S, Ogawa, H, Ota, Y, Matsumoto, Y, Otsuka, S, Namii, Y, Kasai, Y, Kato, N, Nakayama, M, Sato, H, Inaba, S, Shibata, M, Yamashita, H, Yamamoto, J & Yamaguchi, M 2018, 'Aortic stenosis is a risk factor for all-cause mortality in patients on dialysis: A multicenter prospective cohort analysis', BMC Nephrology, vol. 19, no. 1, 80. https://doi.org/10.1186/s12882-018-0877-6

TY - JOUR

T1 - Aortic stenosis is a risk factor for all-cause mortality in patients on dialysis

T2 - A multicenter prospective cohort analysis

AU - Inaguma, Daijo

AU - Sasakawa, Yuji

AU - Suzuki, Noriko

AU - Ito, Eri

AU - Takahashi, Kazuo

AU - Hayashi, Hiroki

AU - Koide, Shigehisa

AU - Hasegawa, Midori

AU - Yuzawa, Yukio

AU - Tamai, Hirofumi

AU - Tsutsui, Shuichi

AU - Ueda, Takuya

AU - Narita, Yukio

AU - Sofue, Fumio

AU - Hirano, Yasuhiro

AU - Motokawa, Masahiro

AU - Miwa, Masamiki

AU - Suzuki, Nobuo

AU - Kojima, Shinichiro

AU - Takatsu, Hisato

AU - Akahori, Toshiyuki

AU - Murakami, Kazutaka

AU - Shimano, Yasunobu

AU - Miyazaki, Takashi

AU - Baba, Kaori

AU - Iida, Yoshiyasu

AU - Endo, Haruki

AU - Furuya, Ryuichi

AU - Aoyama, Isao

AU - Mizutani, Yasuhide

AU - Seno, Hachiro

AU - Nagaya, Takashi

AU - Kasuga, Hirotake

AU - Sugiyama, Satoshi

AU - Kojima, Kanako

AU - Fujisawa, Kazuhiro

AU - Naruse, Tomohiko

AU - Ishida, Osamu

AU - Oishi, Hideto

AU - Ono, Akira

AU - Shimizu, Hideaki

AU - Kato, Kiyonari

AU - Ito, Isao

AU - Yasutomi, Shinji

AU - Yamazaki, Chikao

AU - Yasuda, Kaoru

AU - Matsuoka, Teppei

AU - Tsuruta, Yoshinari

AU - Mizuno, Masao

AU - Ono, Masataka

AU - Okada, Masahiro

AU - Tanoue, Akiko

AU - Obayashi, Takaaki

AU - Yokoyama, Itsuo

AU - Kushimoto, Hiroko

AU - Hasegawa, Hiroshi

AU - Kawasumi, Masao

AU - Nomura, Atsushi

AU - Sakurauchi, Yasuhiro

AU - Yamashita, Mitsuru

AU - Asada, Hiroaki

AU - Ohara, Keiji

AU - Koyabu, Sukenari

AU - Tada, Masashi

AU - Sato, Fumihiko

AU - Yamaguchi, Satoshi

AU - Ogawa, Hiroshi

AU - Ota, Yoshihiro

AU - Matsumoto, Yoshihiro

AU - Otsuka, Satoki

AU - Namii, Yasushi

AU - Kasai, Yasushi

AU - Kato, Nobuo

AU - Nakayama, Makoto

AU - Sato, Haruo

AU - Inaba, Shinichiro

AU - Shibata, Masaya

AU - Yamashita, Hiroshi

AU - Yamamoto, Junichiro

AU - Yamaguchi, Makoto

PY - 2018/4/3

Y1 - 2018/4/3

N2 - Background: Aortic stenosis (AS) is common in patients on dialysis as well as in the general population. AS leads to difficulty with dialysis therapy because of unstable conditions such as intradialytic hypotension due to low cardiac output. However, the precise morbidity rates and risk factors of AS in patients on dialysis are unknown. Moreover, there are no large-scale observational studies regarding the association between AS in patients on dialysis and mortality. Therefore, we will investigate whether morbidity of AS in patients on dialysis is associated with mortality. Methods: This is a multicenter prospective cohort analysis in the Tokai region of Japan. The 75 participating centers in this study will enroll approximately 2400 patients during 12 months, with or without AS. We started enrollment in July 2017 and will follow patents until June 2023. Transthoracic echocardiography will be performed to evaluate aortic valve. Parameters used for evaluation of aortic valve are mean pressure gradient between left ventricle and ascending aorta, aortic valve area, and maximum aortic jet velocity. We will diagnose AS using the criteria based on the 2014 American Heart Association/American College of Cardiology Guideline. We will also perform transthoracic echocardiography at 12, 24, 36, 48, and 60 months. Survival prognosis and CV events will be determined at the end of June 2019, 2020, 2021, 2022, and 2023. Development of AS will be also evaluated as new onset or annual change in AS parameters. We will classify patients based on the presence or absence of AS and the stages of AS and will compare outcomes. Study outcomes will include the following: 1) all-cause mortality rates; 2) incidence of cardiovascular (CV) events; 3) CV-related mortality rates; 4) infection-related mortality rates; 5) new onset or development of AS. Discussion: We will consider the following hypotheses in this study, among others: The prevalence of AS is higher in dialysis patients; new onset and development of AS are associated with factors that are specific for dialysis, such as hyperphosphatemia, hyperparathyroidism, and medication; and outcomes in AS patients are poorer than in patients without AS at baseline. Trial registration: UMIN000026756, Registered March 29 2017.

AB - Background: Aortic stenosis (AS) is common in patients on dialysis as well as in the general population. AS leads to difficulty with dialysis therapy because of unstable conditions such as intradialytic hypotension due to low cardiac output. However, the precise morbidity rates and risk factors of AS in patients on dialysis are unknown. Moreover, there are no large-scale observational studies regarding the association between AS in patients on dialysis and mortality. Therefore, we will investigate whether morbidity of AS in patients on dialysis is associated with mortality. Methods: This is a multicenter prospective cohort analysis in the Tokai region of Japan. The 75 participating centers in this study will enroll approximately 2400 patients during 12 months, with or without AS. We started enrollment in July 2017 and will follow patents until June 2023. Transthoracic echocardiography will be performed to evaluate aortic valve. Parameters used for evaluation of aortic valve are mean pressure gradient between left ventricle and ascending aorta, aortic valve area, and maximum aortic jet velocity. We will diagnose AS using the criteria based on the 2014 American Heart Association/American College of Cardiology Guideline. We will also perform transthoracic echocardiography at 12, 24, 36, 48, and 60 months. Survival prognosis and CV events will be determined at the end of June 2019, 2020, 2021, 2022, and 2023. Development of AS will be also evaluated as new onset or annual change in AS parameters. We will classify patients based on the presence or absence of AS and the stages of AS and will compare outcomes. Study outcomes will include the following: 1) all-cause mortality rates; 2) incidence of cardiovascular (CV) events; 3) CV-related mortality rates; 4) infection-related mortality rates; 5) new onset or development of AS. Discussion: We will consider the following hypotheses in this study, among others: The prevalence of AS is higher in dialysis patients; new onset and development of AS are associated with factors that are specific for dialysis, such as hyperphosphatemia, hyperparathyroidism, and medication; and outcomes in AS patients are poorer than in patients without AS at baseline. Trial registration: UMIN000026756, Registered March 29 2017.

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UR - http://www.scopus.com/inward/citedby.url?scp=85044767699&partnerID=8YFLogxK

U2 - 10.1186/s12882-018-0877-6

DO - 10.1186/s12882-018-0877-6

M3 - Article

C2 - 29614972

AN - SCOPUS:85044767699

SN - 1471-2369

VL - 19

JO - BMC Nephrology

JF - BMC Nephrology

IS - 1

M1 - 80

ER -

Aortic stenosis is a risk factor for all-cause mortality in patients on dialysis: A multicenter prospective cohort analysis

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