Acute Kidney Injury Following Transcatheter Aortic Valve Implantation: Association with Contrast Media Dosage and Contrast Media Based Risk Predication Models

Sudarsky, Doron; Drutin, Yarden; Kusniec, Fabio; Grosman‐Rimon, Liza; Lubovich, Alla; Kinany, Wadia; Hazanov, Evgeni; Gelbstein, Michael; Birati, Edo Y.; Marai, Ibrahim

doi:10.3390/jcm11051181

Cited by 7 publications

(4 citation statements)

References 58 publications

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“…Similar to our study, Sudarsky et al [22] conducted research to determine the incidence of AKI following TAVR. They reported an incidence of 18.1%, which is consistent with our findings.…”

Section: Discussionsupporting

confidence: 55%

Prevalence and Risk Factors Associated With Acute Kidney Injury After Transcatheter Aortic Valve Replacement at a Tertiary Hospital in Riyadh, Saudi Arabia

Alhamad,

Almohaimeed,

Alhayzan

et al. 2023

Cureus

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Background: Despite recent advancements in techniques, peri- and post-procedural complications still pose a significant challenge in the high-risk transcatheter aortic valve replacement (TAVR) patient population. This study aims to investigate and assess the prevalence of acute kidney injury (AKI) following TAVR, and to identify the risk factors associated with its occurrence. Methods: We conducted the study at King Abdulaziz Medical City, Riyadh, Saudi Arabia from January 2016 to December 2022. We extracted data from electronic medical records. We categorized and compared patients based on their diagnosis of AKI+ following TAVR, or their absence of AKI- after the procedure. Results: The study included a total of 344 patients who underwent TAVR. The mean age of the patients was 77.8 ± 8.9 years, 61.8% were male, and the average body mass index was 30.5±7.0. In terms of comorbidities, 70.8% of the patients had diabetes mellitus, 80.5% had hypertension, 8.7% had hypothyroidism, 2.0% had hematological disorders, 23.6% had congestive heart disease, 20.4% had cerebrovascular disease, 4.1% had peripheral vascular disease, 7.3% had cancer, and 34.4% had other comorbidities. The prevalence of AKI was 60 (17.50%) following the procedure. Cerebrovascular diseases showed a significant association with AKI (OR= 3.381, 95% CI, 1.65-6.91, p = 0.001). Chronic kidney disease has a significant effect on AKI (OR = 2.56, 95%CI, 1.02-6.39, p = 0.044). The creatinine level on Day 0 has a significant association with AKI (OR = 1.01, 95%CI, 1.006-1.017, p = 0.0001). Conclusions: These findings highlight the importance of assessing and managing these risk factors (cerebrovascular diseases, chronic kidney disease, and creatinine level on Day 0) in TAVR patients to mitigate the occurrence and severity of AKI. By understanding and addressing these factors, healthcare providers can potentially improve patient outcomes and reduce the incidence of AKI-associated TAVR procedures.

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“…Similar to our study, Sudarsky et al [22] conducted research to determine the incidence of AKI following TAVR. They reported an incidence of 18.1%, which is consistent with our findings.…”

Section: Discussionsupporting

confidence: 55%

Prevalence and Risk Factors Associated With Acute Kidney Injury After Transcatheter Aortic Valve Replacement at a Tertiary Hospital in Riyadh, Saudi Arabia

Alhamad,

Almohaimeed,

Alhayzan

et al. 2023

Cureus

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“…A recent study calls into question the causative role of CM in CI-AKI in patients undergoing TAVI. Because higher CM volumes did not result in an increase in CI-AKI incidence, the greatest risk comes from pre-procedural low GFR values and procedural factors such as periprocedural hypotension ( 165 , 166 ). The same can be said for MitraClip interventional procedures.…”

Section: Applicability In Non-coronary Interventional Proceduresmentioning

confidence: 99%

Contrast-induced acute kidney injury and its contemporary prevention

Sůva¹,

Kala²,

Poloczek³

et al. 2022

Front. Cardiovasc. Med.

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The complexity and application range of interventional and diagnostic procedures using contrast media (CM) have recently increased. This allows more patients to undergo procedures that involve CM administration. However, the intrinsic CM toxicity leads to the risk of contrast-induced acute kidney injury (CI-AKI). At present, effective therapy of CI-AKI is rather limited. Effective prevention of CI-AKI therefore becomes crucially important. This review presents an in-depth discussion of CI-AKI incidence, pathogenesis, risk prediction, current preventive strategies, and novel treatment possibilities. The review also discusses the difference between CI-AKI incidence following intraarterial and intravenous CM administration. Factors contributing to the development of CI-AKI are considered in conjunction with the mechanism of acute kidney damage. The need for ultimate risk estimation and the prediction of CI-AKI is stressed. Possibilities of CI-AKI prevention is evaluated within the spectrum of existing preventive measures aimed at reducing kidney injury. In particular, the review discusses intravenous hydration regimes and pre-treatment with statins and N-acetylcysteine. The review further focuses on emerging alternative imaging technologies, alternative intravascular diagnostic and interventional procedures, and new methods for intravenous hydration guidance; it discusses the applicability of those techniques in complex procedures and their feasibility in current practise. We put emphasis on contemporary interventional cardiology imaging methods, with a brief discussion of CI-AKI in non-vascular and non-cardiologic imaging and interventional studies.

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“…Sudarsky et al 31 discovered that baseline GFR of ≤45 mL/min/1.73 m2 was an independent risk factor for AKI. The baseline GFR was also reported by Bassat et al 32 to be an independent risk factor for AKI.…”

Section: Discussionmentioning

confidence: 99%

The predictive value of neutrophil to lymphocyte ratio and mean platelet volume on acute kidney injury after TAVI

Turen¹,

Yılmaz

2022

SYBD

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Objective: Transcatheter aortic valve implantation (TAVI) is an effective treatment for severe aortic stenosis. Acute kidney injury (AKI) is a common complication after TAVI. The development of AKI after TAVI has been linked to the thromboinflammatory response as evaluated by the neutrophil-to-lymphocyte ratio (NLR) and mean platelet volume (MPV). We sought to determine the predictive value of NLR and MPV on AKI after TAVI in this study. Method: This is a single-center retrospective study. Baseline, peri-procedural, and post-procedural demographic, laboratory, and clinical characteristics were assessed for AKI. The optimal NLR and MPV cut-off values for predicting AKI were determined using receiver operating characteristic (ROC) curve analysis. Results: A total of 184 consecutive patients (age 79.4 ± 7.8 years, 61.4% female) who underwent TAVI were included in this study. The optimal cut-off points for the NLR and MPV were 5.70 (AUC: 0.790; 95% CI: 0.711-0.869, p<0.001 and sensitivity= 80.0%, specificity= 65.2%) and 9.15 fL (AUC:0.713; 95% CI: 0.629-0.997, p<0.001 and sensitivity=70.7%, specificity=63.6%), respectively. AKI occurred in 41 (22.3%) patients included in the study and 6 (3.3%) required dialysis. Baseline GFR (OR: 0.98; 95% CI: 0.94-0.99, p = 0.001), post-procedural WBC count (OR: 1.17; 95% CI: 1.03-1.33, p= 0.02), post-procedural NLR≥ 5.7 (OR: 5.16; 95% CI: 1.84-14.48, p= 0.002), and post-procedural MPV ≥ 9.15 fL (OR: 3.70; 95% CI: 1.54–8.91, p= 0.004) were found to be the independent predictors of AKI after TAVI in multivariable analysis. Conclusion: Post-procedural NLR and MPV were found to be independent predictors of AKI after TAVI.

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Acute Kidney Injury Following Transcatheter Aortic Valve Implantation: Association with Contrast Media Dosage and Contrast Media Based Risk Predication Models

Cited by 7 publications

References 58 publications

Prevalence and Risk Factors Associated With Acute Kidney Injury After Transcatheter Aortic Valve Replacement at a Tertiary Hospital in Riyadh, Saudi Arabia

Prevalence and Risk Factors Associated With Acute Kidney Injury After Transcatheter Aortic Valve Replacement at a Tertiary Hospital in Riyadh, Saudi Arabia

Contrast-induced acute kidney injury and its contemporary prevention

The predictive value of neutrophil to lymphocyte ratio and mean platelet volume on acute kidney injury after TAVI

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