Valvular heart disease in patients on kidney replacement therapy: "opening Pandora's box".

Valvular heart disease (VHD) is highly prevalent among dialysis patients, affecting up to 30%-40% of the population. Aortic and mitral valves are the most frequently affected and commonly lead to valvular stenosis and regurgitation. Although it is well established that VHD is associated with a high morbimortality burden, the optimal management strategy remains unclear, and treatment options are limited due to the high risk of complications and mortality after surgical and transcatheter interventions. In this issue of Clinical Kidney Journal, Elewa et al. provide new evidence in this field by reporting the prevalence and associated outcomes of VHD in patients with kidney failure on renal replacement therapy.