Advanced chronic kidney disease in patients undergoing transcatheter aortic valve implantation: insights on clinical outcomes and prognostic markers from a large cohort of patients

Abstract

Advanced CKD was associated with a higher rate of early and late mortality and bleeding events following TAVI, with AF and dialysis therapy determining a higher risk in these patients. The mortality rate of patients with both factors was unacceptably high and this should be taken into account in the clinical decision-making process in this challenging group of patients.

Moderate and Severe Preoperative Chronic Kidney Disease Worsen Clinical Outcomes After Transcatheter Aortic Valve Implantation

“…[10][11][12][13][17][18][19][20][21] The characteristics of the included studies are reported in Table 1. There was no significant variability in the CKD definitions used across the studies.…”

“…In particular, the higher risk of mortality has been suggested in patients with more severe CKD. [10][11][12]17,20 However, recent data showed that advanced CKD (stages 4-5), but not moderate CKD (stage 3), was a predictor of early and late mortality. 10,11 In contrast, other studies did not find a significant relationship between CKD and worse outcomes.…”

Changes in kidney function among patients undergoing transcatheter aortic valve replacement

“…Thus, improvement in cardiac functions after TAVR likely plays a significant role in an improvement in kidney function. In patients with advanced CKD or dialysis dependence, studies have shown a higher rate of early and late mortality following TAVR (28,29). Despite having poorer outcomes after TAVR compared with non-dialysis patients, TAVR is comparable with SAVR in ESRD patients on dialysis based on a propensity-matched comparison of all Medicare feefor-service patients undergoing TAVR or SAVR (29).…”

Acute Heart Failure in Patients With Severe Aortic Stenosis ― Insights From the CURRENT AS Registry ―

“…Nonetheless, advanced CKD is known to be associated with a rapid progression of AS and poor outcome after surgical AVR or TAVI. [33][34][35][36] Further studies of better risk stratification and treatment strategy in this high-risk category are needed.…”