Prognostic value of renal function in patients with aortic stenosis treated with transcatheter aortic valve replacement

Meneguz‐Moreno, Rafael Alexandre; Ramos, Ana; Siqueira, Dimytri; Castro-Filho, Antonio de; Jatene, Tannas; Jeronimo, Andreia Dias; Bihan, David Costa de Souza Le; Moreira, Adriana; Arrais, Magaly; Abizaid, Alexandre; Sousa, Amanda G. M. R.; Sousa, J. Eduardo

doi:10.1002/ccd.26693

Cited by 14 publications

(8 citation statements)

References 30 publications

(47 reference statements)

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“…Similar to what has been reported in other TAVR cohorts, most of the AKI observed in this study was Stage 1 AKI [2, 10, 14, 27–29]. However, even Stage 1 AKI is associated with increased mortality in ambulatory [8], non-cardiac surgery [7], cardiac surgery [30] and TAVR patients [27, 28]. Thus, it is important to identify risk factors that can potentially be modified to mitigate development of AKI after TAVR.…”

Section: Discussionsupporting

confidence: 90%

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Packed red blood cell transfusion associates with acute kidney injury after transcatheter aortic valve replacement

et al. 2019

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Background Acute kidney injury after cardiac surgery significantly associates with morbidity and mortality. Despite not requiring cardiopulmonary bypass, transcatheter aortic valve replacement patients have an incidence of post-procedural acute kidney injury similar to patients who undergo open surgical aortic valve replacement. Packed red blood cell transfusion has been associated with morbidity and mortality after cardiac surgery. We hypothesized that packed red blood cell transfusion independently associates with acute kidney injury after transcatheter aortic valve replacement, after accounting for other risk factors. Methods This is a single-center retrospective cohort study of 116 patients undergoing transcatheter aortic valve replacement. Post-transcatheter aortic valve replacement acute kidney injury was defined by Kidney Disease: Improving Global Outcomes serum creatinine-based criteria. Univariate comparisons between patients with and without post-transcatheter aortic valve replacement acute kidney injury were made for clinical characteristics. Multivariable logistic regression was used to assess independent association of packed red blood cell transfusion with post-transcatheter aortic valve replacement acute kidney injury (adjusting for pre-procedural renal function and other important clinical parameters). Results Acute kidney injury occurred in 20 (17.2%) subjects. Total number of packed red blood cells transfused independently associated with post-procedure acute kidney injury (OR = 1.67 per unit, 95% CI 1.13–2.47, P = 0.01) after adjusting for pre-procedure estimated glomerular filtration rate (OR = 0.97 per ml/min/1.73m 2 , 95% CI 0.94–1.00, P = 0.05), nadir hemoglobin (OR = 0.88 per g/dL increase, CI 0.61–1.27, P = 0.50), and post-procedure maximum number of concurrent inotropes and vasopressors (OR = 2.09 per inotrope or vasopressor, 95% CI 1.19–3.67, P = 0.01). Conclusion Packed red blood cell transfusion, along with post-procedure use of inotropes and vasopressors, independently associate with acute kidney injury after transcatheter aortic valve replacement. Further studies are needed to elucidate the pathobiology underlying these associations.

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Section: Discussionsupporting

confidence: 90%

“…Contrast dose did not associate with AKI in our cohort of TAVR patients. Contrast dose also did not associate with post-TAVR AKI in several other TAVR cohort studies [11, 14, 15, 19, 27–29, 31, 32].…”

Section: Discussionmentioning

confidence: 75%

Packed red blood cell transfusion associates with acute kidney injury after transcatheter aortic valve replacement

et al. 2019

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“…In the present issue of Catheterization and Cardiovascular Interventions , Meneguz‐Moreno et al evaluated the clinical variables related to changes in renal function following TAVR and the impact of AKI on outcomes . The authors were able to provide further evidence of an independent association between level of renal dysfunction before TAVR and incidence of AKI after implantation, which had been described previously in the literature .…”

mentioning

confidence: 54%

Transcatheter aortic valve replacement and renal function: A complex relationship

Rodriguez

Prasad

2017

Cathet Cardio Intervent

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“…A study showed that there are a variety of factors linked with AKI following TAVR such as high preoperative creatinine levels, the need for blood transfusion, peripheral vascular disease, and hypertension and thus, the short term mortality (<30 days) in patients who developed AKI after TAVR and was higher compared to those without AKI [14]. Baseline glomerular filtration rate is an independent predictor of acute kidney injury in patients undergoing TAVR which adversely affects 30-day and one-year mortality [15]. A study found that male sex, left ventricular ejection fraction <30%, atrial fibrillation, and advanced chronic kidney disease were independently associated with higher mortality in patients receiving TAVR in predialysis or dialysis individuals [16].…”

Section: Discussionmentioning

confidence: 99%

Aortic Stenosis Patients With Transcatheter Aortic Valve Replacement: Caution Recommended With Renal Failure During Hospitalization

Kaur

Ajibawo

Yomi

et al. 2020

Cureus

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Our study aimed to assess the risk of in-patient mortality due to renal failure and other comorbidities in aortic stenosis (AS) patients undergoing transcatheter aortic valve replacement (TAVR). Methods We conducted a cross-sectional study using a Nationwide Inpatient Sample (NIS, January 2010 to December 2014) from the United States and included 33,325 patients with a primary diagnosis of AS. Logistic regression was used to evaluate the odds ratio (OR) for in-hospital mortality in AS by comorbidities including renal failure.

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Prognostic value of renal function in patients with aortic stenosis treated with transcatheter aortic valve replacement

Abstract: In this TAVR cohort, baseline GFR was the only independent predictor of AKI, which negatively impacted on 30-day and 1-year mortality. © 2016 Wiley Periodicals, Inc.

Cited by 14 publications

References 30 publications

Packed red blood cell transfusion associates with acute kidney injury after transcatheter aortic valve replacement

Packed red blood cell transfusion associates with acute kidney injury after transcatheter aortic valve replacement

Transcatheter aortic valve replacement and renal function: A complex relationship

Aortic Stenosis Patients With Transcatheter Aortic Valve Replacement: Caution Recommended With Renal Failure During Hospitalization

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