Acute Kidney Injury Following Aortic Valve Replacement in Patients Without Chronic Kidney Disease

Moriyama, Noriaki; Laakso, Teemu; Raivio, Peter; Dahlbacka, Sebastian; Kinnunen, Esko; Juvonen, Tatu; Valtola, Antti; Husso, Annastiina; Jalava, Maina P.; Ahvenvaara, Tuomas; Tauriainen, Tuomas; Piuhola, Jarkko; Lahtinen, Asta; Niemelä, Matti; Mäkikallio, Timo H.; Virtanen, Marko; Maaranen, Pasi; Eskola, Markku; Savontaus, Mikko; Airaksinen, Juhani; Biancari, Fausto; Laine, Mika

doi:10.1016/j.cjca.2020.03.015

Cited by 11 publications

(9 citation statements)

References 32 publications

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“…In the current issue of the Canadian Journal of Cardiology, Moriyama and colleagues fill this gap, reporting on the incidence and long-term impact of AKI in a large multicentre registry comprising 4555 subjects with normal renal function undergoing either SAVR or TAVR. 11 The authors report that AKI had an overall incidence of 12.5% in subjects undergoing aortic valve replacement, with significantly higher figures for SAVR compared with TAVR (19.0% vs 5.9%, P < 0.001, in the propensity score-matched population). Bleeding complications were consistently associated with AKI in both cohorts.…”

Section: See Article By Moriyama Et Al Pages 37e46 Of This Issuementioning

confidence: 97%

“…AKI was linked to an increased risk of 5-year all-cause death (adjusted hazard ratio: 2.14, 95% confidence interval: 1.69-2.67, P < 0.001), with more severe degrees of AKI associated with higher mortality rates. 11 The authors are to be congratulated for this well-conducted multicentre registry, with robust data including a SAVR control group, rigourous adjustment by propensity-score matching, and the use of the Kidney Disease-Improving Global Outcomes (KDIGO) 12 definition of AKI, which allows for an easy comparison with previous and future studies. On the other hand, several limitations have also to be acknowledged.…”

Section: See Article By Moriyama Et Al Pages 37e46 Of This Issuementioning

confidence: 99%

“…What can we take home from the study by Moriyama et al 11 to improve the outcomes of patients undergoing SAVR or TAVR? The authors clearly showed that AKI also happens frequently in patients with an eGFR 60 mL/min per 1.73 m 2 and that AKI risk is strongly related to periprocedural bleeding.…”

Section: See Article By Moriyama Et Al Pages 37e46 Of This Issuementioning

confidence: 99%

See 2 more Smart Citations

Acute Kidney Injury in Patients With Normal Renal Function Undergoing Transcatheter or Surgical Aortic Valve Replacement: Should We Be Concerned?

Azzalini

Moroni

2021

Canadian Journal of Cardiology

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Section: See Article By Moriyama Et Al Pages 37e46 Of This Issuementioning

confidence: 97%

Section: See Article By Moriyama Et Al Pages 37e46 Of This Issuementioning

confidence: 99%

See 1 more Smart Citation

Acute Kidney Injury in Patients With Normal Renal Function Undergoing Transcatheter or Surgical Aortic Valve Replacement: Should We Be Concerned?

Azzalini

Moroni

2021

Canadian Journal of Cardiology

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“…Compared to non-cardiac surgery, cardiac surgery has special characteristics, such as high rates and volumes of exogenous blood product transfusion, that make patients more susceptible to AKI [10]. Glomerular filtration rate (eGFR) <30-44 mL/min/1.73m 2 , is associated with increased inhospital and long-term mortality rate [5,[11][12][13][14][15].…”

Section: Introductionmentioning

confidence: 99%

A Novel Understanding of Serum Creatinine Levels as a Predictive Factor for Mortality Outcome in Aortic Disease

Cosmin¹,

Harpa²,

Oprean³

et al. 2022

Preprint

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Acute renal injury (AKI) is a complication that can occur after cardiac surgery, and since technological advancements and knowledge in medicine are exponentially expanding, it requires ongoing research. The study aims to evaluate the outcome of the treated electives of emergency aortic disease with high serum creatinine levels (SCr). Methods: The cohort included 183 patients, all of whom had an aortic disease and whose SCr levels were checked upon admission on the first day in the intensive care unit (ICU) and upon discharge from the hospital. We correlated SCr levels with in-hospital mortality and immediate mortality at least six months after discharge, with cross- clamp time and bypass time. Results: A high SCr level upon admission significantly predicts in- hospital mortality (p = 0.001) but not immediate mortality (p = 0.409). There is also a statistically significant correlation between the elevated SCr levels on the first day of ICU and aortic disease (p = 0.041) but not with immediate mortality (p = 0.119). We found a significant correlation between aortic disease and in-hospital mortality (p < 0.001) but no correlation between high SCr level on the first day of ICU and immediate mortality (p = 0.119). The cross-clamp time had a statistically significant correlation with elevated SCr level (p = 0.013) and in-hospital mortality (p = 0.001) but not with immediate mortality (p = 0.847). Furthermore, the bypass time was negatively correlated with a high SCr level on the first day of ICU (p = 0.090), with in-hospital mortality (p = 0.410) and immediate mortality (p = 0.625). We also found that patients with an aortic disease were not correlated with elevated creatinine levels at ICU discharge (p = 0.152) or long-term mortality (p = 0.106). Conclusions: The study only included a small portion of the elaborate surgical and medical management developed around cardiac patients who received invasive treatment. The conclusions 40 reached were nevertheless clearly relevant, evidenced by the significantly correlated statistics. This element, moving forward, motivates us to expand our research’s range, collect the most newly relevant data, and use it to benefit the patient; this work provides the beginning step in this process.

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“…Compared with noncardiac surgery, cardiac surgery has unique characteristics, such as high rates and volumes of exogenous blood product transfusion, that make patients more susceptible to AKI [10]. Glomerular filtration rate (eGFR) < 30-44 mL/min/1.73 m 2 is associated with increased in-hospital and long-term mortality rates [5,[11][12][13][14][15].…”

Section: Introductionmentioning

confidence: 99%

A New Understanding of Serum Creatinine Levels as a Predictive Factor of Mortality Outcomes in Aortic Disease

Cosmin¹,

Harpa²,

Deac³

et al. 2022

Preprint

View full text Add to dashboard Cite

Acute kidney injury (AKI) is a complication that can occur after cardiac surgery and requires ongoing research in light of the exponential expansion of technological advancements and knowledge in medicine. In this study, we aim to evaluate the outcomes of treated electives of emergency aortic disease with high serum creatinine levels (SCr). Methods: The cohort includes 183 patients, all of whom have an aortic disease and whose SCr levels were checked upon admission on the first day in the intensive care unit (ICU) and upon discharge from the hospital. We examined the correlation of SCr levels with in-hospital mortality and immediate mortality at least six months after discharge as well as with cross-clamp time and bypass time.Results: A high SCr level upon admission is a significant predictive factor of n-hospital mortality (p = 0.001) but not immediate mortality (p = 0.409). A statistically significant correlation was also observed between elevated SCr level on the first day of ICU and aortic disease (p = 0.041) but not immediate mortality (p = 0.119). We observed a significant correlation between aortic disease and in-hospital mortality (p < 0.001), but no correlation was found between high SCr level on the first day of ICU and immediate mortality (p = 0.119). The cross-clamp time is statistically significant correlated with elevated SCr level (p = 0.013) and in-hospital mortality (p = 0.001) but not immediate mortality (p = 0.847). Furthermore, the bypass time is negatively correlated with a high SCr level on the first day of ICU (p = 0.090), in-hospital mortality (p = 0.410), and immediate mortality (p = 0.625). We also found that aortic disease is not correlated with elevated creatinine levels at ICU discharge (p = 0.152) or long-term mortality (p = 0.106). Conclusions: Although this study only included a small portion of the elaborate aspects of surgical and medical management developed around cardiac patients who received invasive treatment, the conclusions reached are nevertheless clearly relevant, as evidenced by the significantly correlations uncovered. In order to manage AKI after AAS and improve the outcome, the SCr level could be used as a marker for renoprotective strategy. Moving forward, these results serve as a first step in motivating us to expand the range of our research, collect newly relevant data, and use it to benefit patients.

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Acute Kidney Injury Following Aortic Valve Replacement in Patients Without Chronic Kidney Disease

Cited by 11 publications

References 32 publications

Acute Kidney Injury in Patients With Normal Renal Function Undergoing Transcatheter or Surgical Aortic Valve Replacement: Should We Be Concerned?

Acute Kidney Injury in Patients With Normal Renal Function Undergoing Transcatheter or Surgical Aortic Valve Replacement: Should We Be Concerned?

A Novel Understanding of Serum Creatinine Levels as a Predictive Factor for Mortality Outcome in Aortic Disease

A New Understanding of Serum Creatinine Levels as a Predictive Factor of Mortality Outcomes in Aortic Disease

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