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Background: Aortic stenosis (AS) can present with dyspnea, angina, syncope, and palpitations and this presents a diagnostic challenge as chronic kidney disease (CKD) and other commonly found comorbid conditions may present similarly. While medical optimization is an important aspect in management, aortic valve replacement (AVR) by surgical aortic valve replacement (SAVR) or transcatheter aortic valve replacement (TAVR) is the definitive treatment. Patients with concomitant CKD and AS require special consideration as it is known that CKD is associated with progression of AS and poor long-term outcomes. Aims and objectives: To summarize and review current existing literature on patients with both CKD and AS regarding disease progression, dialysis method, surgical intervention, and post operative outcomes. Conclusion: The incidence of aortic stenosis increases with age but has also been independently associated with chronic kidney disease and furthermore with hemodialysis. Regular dialysis with hemodialysis vs. peritoneal dialysis and female gender have been associated with progression of AS. Management of aortic stenosis is multidisciplinary and requires planning and interventions by the “Heart-Kidney Team” to decrease risk of further inducing kidney injury among high-risk population. Both TAVR and SAVR are effective interventions for patients with severe symptomatic AS, but TAVR has been associated with better short-term renal and cardiovascular outcomes. Implications for practice: Special consideration must be taken in patients with both CKD and AS. The choice of whether to undergo hemodialysis (HD) vs. peritoneal dialysis (PD) among patients with CKD is multifactorial but studies have shown benefit regarding AS progression among those who undergo PD. The choice regarding AVR approach is likewise the same. TAVR has been associated with decreased complications among CKD patients, but the decision is multifactorial and requires a comprehensive discussion with the Heart-Kidney Team as many other factors play a role in the decision including preference, prognosis, and other risk factors.

Ixora coccinea L. (santan) and Mimosa pudica L. (makahiya) ethanolic and aqueous extracts were screened for their in vitro antacid potentials using the preliminary antacid test, determination of acid neutralization capacity, acid neutralizing effect, duration of consistent neutralization, and buffering capacity. Phytochemical screening and quantification of alkaloids were also done and the alkaloid content was correlated to the in vitro antacid potentials of the extracts. Among the extracts, the M. pudica aqueous extract gave the best preliminary antacid test result (1.0066±0.0083 pH) and acid neutralization capacity (0.0711±0.0038 mmol H+). Its aqueous extract showed comparable acid neutralizing effect (3.507% acid neutralized) on gastric juice with that of its ethanol extract (3.509% acid neutralized). On the other hand, the I. coccinea aqueous extract had the highest acid buffering capacity (0.0701±0.0020 mmol H+/pH). Both aqueous extracts gave the longest duration of neutralization with 9±1.732 minutes. All the extracts were tested positive for flavonoids, indoles, tannins, anthraquinones, anthrones, and alkaloids, with the I. coccinea aqueous extract having the highest alkaloid content (18.0282±1.2607% w alkaloid/w extract). This study provides the first reported proof of the antacid activities of I. coccinea and M. pudica. Further tests, including mouse model assays, are suggested to determine the efficacy of the extracts in vivo.