E-13 | Transcatheter Aortic Valve Replacement Outcomes in End-Stage Renal Disease Patients Undergoing Peritoneal Dialysis Versus Hemodialysis: From National Inpatient Sample 2016-2020

In this study, we evaluated TAVR outcomes in peritoneal dialysis (PD) patients compared to hemodialysis (HD) patients using a large National Inpatient Sample (NIS) database. Retrospective studies have shown worse outcomes in these patients undergoing TAVR. Data on outcomes in ESRD patients on PD has been limited. The NIS was queried to identify adults with ESRD who underwent TAVR, then stratified into HD and PD groups using ICD-10-CM and PCS codes. HD controls were derived using propensity score matching for demographics and comorbidities. The outcomes were inpatient mortality and complications, length of stay (LOS), and total hospital charge (THC). Multivariate logistic regression analyses were used. Among ESRD patients undergoing TAVR, 500 were on PD, and 6,250 had HD. 150 patients (2.4%) died in the HD group, with no fatality in the PD group. Upon matched analyses, the PD group showed shorter LOS (mean 2.2 fewer days, 95% CI [1.28 to 3.13 days], p=<0.001), lower THC (mean $56,728 less, 95% CI [33,480 to 79,976], p<0.001), as well as lower odds of complications, mainly cardiogenic shock (0.32, [0.14-0.73], p=0.007), intra-aortic balloon pump (IABP) use (0.38, [0.15-0.98], p=0.045), periprocedural cardiac (0.15, [0.03-0.85], p=0.032), and access site complications (0.15, [0.03-0.74], p=0.020)(Table 1). PD patients undergoing TAVR had lower odds of life-threatening complications, mainly cardiogenic shock requiring IABP, cardiac arrest, and periprocedural cardiac complications, but similar odds of strokes to HD patients. Moreover, PD patients showed reduced hospital burden with lesser LOS and THC.