Introduction:
By combining both "traditional" and specific risk factors, chronic hemodialysis patients (CHD) are more exposed to cardiovascular complications than the general population. Hypertension, diabetes, dyslipidemia, anemia, infectious endocarditis, and malnutrition are predisposing factors for dialysis patients to develop valvular diseases. The prevalence of valvulopathies can reach up to 14% in this population. Valvular surgery is associated with high mortality particularly in CHD patients. We aimed to analyze the clinical profiles of CHD patients undergoing valvular surgery and to identify the risk factors for mortality.
Methods:
A total of 67 CHD patients were included. We collected their clinical data, detailed their therapeutic management, and recorded both in-hospital and long-term complications.
Results:
The average age of the patients is 51 ± 13 years, and the duration of hemodialysis is 7 ± 4 years. Hypertension is found in 65% of the patients, and secondary hyperparathyroidism in 74%. The most common condition is aortic stenosis, observed in 34 patients. The most frequently performed surgical procedure is aortic valve replacement, followed by tricuspid valve repair in respectively 44 and 24 patients. In 16 cases, valve surgery was combined with another surgical procedure. The perioperative mortality rate is 10%, associated with advanced age (p=0.003), diabetes (p=0.003), hypertension (p=0.043), and hyperparathyroidism (p<0.001). The one-year mortality rate is 25%, associated with hypertension (p=0.017), sedentary lifestyle (p=0.033), left ventricular hypertrophy (p=0.028), and combined surgery (p=0.006).
Conclusions:
Valvular surgery in CHD patients is high-risk and performed on patients with multiple comorbidities. Early detection and a multidisciplinary approach to therapeutic management are essential to reduce the morbidity and mortality associated with this type of surgery.
I have no potential conflict of interest to disclose.
I did not use generative AI and AI-assisted technologies in the writing process.