Valvular heart disease in patients with chronic kidney disease – modern aspects of diagnosis and treatment

Valvular heart disease (VHD) is a prevalent and clinically relevant problem in patients with chronic kidney disease (CKD), particularly in those with advanced stages of renal dysfunction or on dialysis. The relationship between CKD and VHD is multifactorial and includes systemic inflammation, endothelial dysfunction, and disturbances in calcium-phosphorus metabolism, which together contribute to accelerated valvular fibrosis and calcification. As a result, patients with CKD are at increased risk of developing aortic stenosis (AS) and mitral regurgitation (MR), the two most common valvular pathologies in this population. Less common but more serious are the episodes of infective endocarditis (IE) in dialysis patients. Patients with CKD on hemodialysis have a 40- to 60-fold higher risk of IE than the general population.