Acute kidney injury following transcatheter aortic valve implantation: incidence, predictors and clinical outcome

92 Transcatheter Aortic Valve Implantation in Patients with Pre-existing Chronic Kidney Disease

“…The overall AKI rate (21%) in our study is comparable with reported rates, which vary from as low as 11% [15] to as high as 41% [29] (recognising however that over 80% of the patients in this dataset had poor baseline renal function). There are however subtle differences in the definition of AKI (Supplementary Table 1), with most studies applying either VARC-defined or modified RIFLE criteria, whilst others use AKIN.…”

“…Elhimidi et al [43] demonstrated pre-procedural serum creatinine level to be a predictor of AKI (OR [95% CI] 3.7 (1.24-11.3); p = 0.019) as did Khawaja et al [44] (OR [95% CI] 1.57 (1.11-2.21); p = 0.010) who also, like our study found pre-existing diabetes to strongly predict AKI. Other series however have not found an association between baseline renal function or the presence of CKD and AKI development after TAVI [29,41,45,46]. Post-operative red blood cell (RBC) transfusion has been strongly implicated in the literature as an independent predictor of AKI following TAVI [39,41,[46][47][48][49][50] but did not reach statistical significance in our multivariate model.…”

“…Only six (5.3%) patients required post-operative RBC transfusion overall and although a greater proportion belonged to the group who did develop AKI compared to those who did not (12.5% vs. 3.3%, p = 0.107, Supplementary Table 4) this was not a statistically significant difference and was therefore likely underpowered in our model. AKI has also been shown to be independently associated with peripheral vascular disease [41,[44][45][46], elevated leucocyte count possibly implicated as part of a systemic inflammatory response syndrome (SIRS) [22,45,46,49] and a transapical approach to TAVI deployment [22,29,48,51,52]. Contrast volume has been shown as an independent predictor for AKI [50,53], but not consistently so [41,45,46].…”

“…Recent studies vary in the frequency of AKI following TAVI, reported as low as 7% [28] and as high as 41% [29], however different definitions of AKI have been used in different studies with heterogeneous populations and varying study sizes. This rate may potentially still be lower than SAVR in patients with pre-existing CKD [15].…”

Incidence, risk factors and prognostic impact of acute kidney injury on 30-day mortality after transcatheter aortic valve implantation

“…Several studies have investigated the incidence and predictors of AKI after TAVI. [4][5][6][7][8][9][10][11][12][13][14] Previous studies have shown that AKI occurs in about 11.7 to 41.7% of patients undergoing TAVI and has been associated with 2-to 5.47-fold increased risk of mortality. [5][6][7][8][9][10] In the present study, we aimed to determine the incidence, predictors, and prognostic impact of AKI on 30-day mortality following TAVI.…”