Hospitalized valvular heart disease in patients on renal transplant waiting list: Incidence, clinical correlates and outcomes

K. C. Abbott*, P. Hashieh, D. Cruess, L. Y.C. Agodoa, P. G. Welch, A. J. Taylor, C. M. Yuan

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

25 Scopus citations


Background: Patients with ESRD are at increased risk for heart valve calcification. It has not been established whether hospitalized valvular heart disease (VHD) is a substantial barrier to renal transplantation (RT) after transplant listing, or whether VHD progresses after RT. Methods: Using data from the USRDS, we studied 35,215 patients with ESRD enrolled on the renal transplant waiting list from July 1994 to June 1997. Cox non-proportional hazards regression models were used to calculate adjusted time-dependent hazard ratios (HR) for RT and VHD. Results: In comparison to maintenance dialysis (2.2/1,000 person years), RT was independently associated with a lower hazard for hospitalization for VHD (0.7/1,000 person years, HR 0.28, 95% confidence interval 0.17 - 0.47). Renal transplant recipients had much lower rates of VHD after transplant than before (rate ratio (RR) 0.49, 95% CI 0.47 - 0.52). Patients with VHD were significantly less likely to receive RT (adjusted rate for RT 0.38, 95% CI 0.20 - 0.45) but patients who received valve replacement surgeries (VRS) were not affected (adjusted rate for RT 1.10, 95% CI 0.52 - 2.32, not significant). Conclusions: VHD is an uncommon but serious barrier to RT after listing, while VRS is not a significant barrier to RT. Established VHD does not appear to worsen after RT. Clinicians should consider giving increased attention to the detection and treatment of VHD during the pre-transplant evaluation.

Original languageEnglish
Pages (from-to)79-87
Number of pages9
JournalClinical Nephrology
Issue number2
StatePublished - 1 Feb 2003
Externally publishedYes


  • Aortic
  • Dialysis
  • End-stage renal disease
  • Hospitalization
  • Mitral
  • Renal transplant
  • Surgery
  • Valvular heart disease


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