PT  - JOURNAL ARTICLE
AU  - Nada Khelifi
AU  - Claudia Blais
AU  - Sonia Jean
AU  - Denis Hamel
AU  - Marie-Annick Clavel
AU  - Philippe Pibarot
AU  - Fabrice Mac-Way
TI  - Temporal trends of aortic stenosis and comorbid chronic kidney disease in the province of Quebec, Canada
AID  - 10.1136/openhrt-2021-001923
DP  - 2022 Jun 01
TA  - Open Heart
PG  - e001923
VI  - 9
IP  - 1
4099  - http://openheart.bmj.com/content/9/1/e001923.short
4100  - http://openheart.bmj.com/content/9/1/e001923.full
SO  - Open Heart2022 Jun 01; 9
AB  - Objective To investigate temporal trends of chronic kidney disease (CKD) among patients with incident aortic stenosis (AS) and to compare these trends with that of a matched control population.Methods Using the Quebec Integrated Chronic Disease Surveillance System, we performed a population-based nested case-control study including 108 780 patients newly hospitalised with AS and 543 900 age-matched, sex-matched and fiscal year-matched patients without AS from 2000 to 2016 in Quebec (Canada). Three subgroups were considered. Dialysis subgroup had at least two outpatient billing codes of dialysis. The predialysis subgroup had at least one hospital or two billing diagnostic codes of CKD. The remaining individuals were included in the non-CKD subgroup. We estimated overall and sex-specific standardised annual proportions of CKD subgroups through direct standardisation using the 2016–2017 age structure of the incident AS cohort. The trends overtime were estimated through fitting robust Poisson regression models. Age-specific distribution of AS and control population were assessed for each subgroup.Results From 2000 to 2016, age-standardised proportions of patients with AS with dialysis and predialysis increased by 41% (99% CI 12.0% to 78.1%) and by 45% (99% CI 39.1% to 51.6%), respectively. Inversely, age-standardised proportions of dialysis and pre-dialysis among non-AS patients decreased by 63% (99% CI 55.8% to 68.7%) and by 32% (99% CI 29.9% to 34.6%), respectively, during the same study period. In patients with and without AS, age-standardised annual proportions of males in predialysis were significantly higher than females in most of the study period. Patients with AS on dialysis and predialysis were younger than their respective controls (dialysis: 29.6% vs 45.1% had ≥80 years, predialysis: 60.8% vs 72.7% had ≥80 years).Conclusions Over time, the proportion of patients with CKD increased significantly and remained consistently higher in incident AS individuals compared with controls. Our results highlight the need to investigate whether interventions targeting CKD risk factors may influence AS incidence in the future.Data are available upon reasonable request.