The association between renal recovery after acute kidney injury and long-term mortality after transcatheter aortic valve replacement
Key result
Acute kidney injury after transcatheter aortic valve replacement increased the risk of 2-year mortality (HR 2.20), with the highest risk observed in patients with no renal recovery (HR 10.95).
Why the study?
Does the extent of renal recovery after acute kidney injury affect 2-year mortality in adult patients surviving to hospital discharge after TAVR?
Population
374 adult patients who survived to hospital discharge after TAVR for aortic stenosis at a quaternary…
Comparison
Acute kidney injury with varying degrees of… vs No AKI
Design
Cohort
Follow-up
2 years
Authors
Discussion
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Member takes
Implication
Any post-TAVR AKI signals higher 2-year mortality risk even with recovery; supports renal-protection trials but should not yet change practice.
Study Design
Type
Cohort (n=374)
Multicenter
No
Structured PICO
Does the extent of renal recovery after acute kidney injury affect 2-year mortality in adult patients surviving to hospital discharge after TAVR?
P
Population
374 adult patients who survived to hospital discharge after TAVR for aortic stenosis at a quaternary referral medical center
I
Intervention
Acute kidney injury (AKI) with varying degrees of renal recovery (complete, partial, or no recovery) at hospital discharge
C
Comparator
No AKI
O
Outcome
2-year mortalityhard clinical
Main Result
Effect estimate: HR 2.20 (95% CI 1.37-3.49)
p-value: p=<0.001
Any degree of AKI after TAVR, even with complete renal recovery at discharge, is associated with an increased risk of 2-year mortality, with worse recovery correlating with higher mortality risk.
Limitations
- Retrospective and observational design, which can create selection biases
- Predominantly white cohort
- Urine output criterion was not used for AKI diagnosis
- Definitions of renal recovery were based on serum creatinine and/or eGFR, which has a nonlinear relation and might be confounding
Cite This Study
Thongprayoon et al. (2017) conducted a cohort in Aortic stenosis (n=374). Acute kidney injury (AKI) vs. No acute kidney injury was evaluated on All-cause mortality 2 years after hospital discharge (HR 2.20, 95% CI 1.37-3.49, p=<0.001). Acute kidney injury after transcatheter aortic valve replacement increased the risk of 2-year mortality (HR 2.20), with the highest risk observed in patients with no renal recovery (HR 10.95).