Key result
In patients with chronic kidney disease undergoing transcatheter aortic valve replacement, the development of acute kidney injury independently increased the risk of all-cause mortality or heart failure hospitalization by 2.3-fold.
Why the study?
LFLG-AS and CKD represent a high-risk subset of patients undergoing TAVR, and the prognostic impact of LFLG-AS and post-TAVR AKI in CKD patients remained to be evaluated.
Does the presence of acute kidney injury and low-flow, low-gradient aortic stenosis worsen outcomes in patients with chronic kidney disease undergoing TAVR?
Cohort (n=324)
No
Does the presence of acute kidney injury and low-flow, low-gradient aortic stenosis worsen outcomes in patients with chronic kidney disease undergoing TAVR?
The combination of low-flow, low-gradient aortic stenosis and acute kidney injury significantly worsens prognosis in patients with chronic kidney disease undergoing TAVR.
Background: Acute kidney injury (AKI) is a common and serious post-transcatheter aortic valve replacement (TAVR) complication that affects patient outcomes. Low-flow, low-gradient (LFLG) aortic stenosis (AS) and chronic kidney disease (CKD) represent a high-risk subset of patients undergoing TAVR. The objective of this study was to evaluate the prognostic impact of LFLG-AS and AKI in CKD patients undergoing TAVR. Methods and Results: A retrospective analysis was conducted on 324 patients with CKD stage G3a-5 who underwent TAVR for severe AS between August 2015 and December 2022. Patients were stratified into 4 groups according to the presence of LFLG- AS and AKI. The primary endpoint was defined as all-cause mortality or heart failure during the 2-year follow-up period. During a median period of 13 months, 46 (14%) patients reached the primary endpoint. The difference between the baseline values for renal function of the patients with AKI or without AKI was not significant. The patients without either condition who had the most favorable outcomes were those without LFLG-AS or AKI. Patients with LFLG-AS only or AKI only had intermediate outcomes. The patients with LFLG-AS and AKI showed significantly higher mortality and adverse outcomes than the other groups (log-rank P<0.001). Conclusions: This study highlighted the severe prognostic implications of AKI for patients with LFLG-AS who undergo TAVR.
No takes yet. Share an insight, caveat, or question.
Nagata et al. (2025) conducted a cohort in Severe aortic stenosis with chronic kidney disease (CKD stage G3a-5) (n=324). Acute kidney injury (AKI) post-TAVR vs. No acute kidney injury was evaluated on All-cause mortality or hospitalization for heart failure (HR 2.30, 95% CI 1.22-4.36, p=0.011). In patients with chronic kidney disease undergoing transcatheter aortic valve replacement, the development of acute kidney injury independently increased the risk of all-cause mortality or heart failure hospitalization by 2.3-fold.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: