Comparative Outcomes of Patients With Advanced Renal Dysfunction Undergoing Transcatheter Aortic Valve Replacement in the United States From 2011 to 2014

Background— Renal dysfunction is intricately linked to aortic stenosis, with over 25% patients presenting for transcatheter aortic valve replacement having chronic kidney disease (CKD). Prevalence and outcomes of patients with CKD, especially those with end-stage renal disease (ESRD), are controversial. We aimed to compare in-hospital outcomes of patients with CKD or ESRD with those patients with no CKD/ESRD. Methods and Results— Data were obtained using the national inpatient sample between the years 2011 and 2014. We used the International Classification of Diseases, Ninth Edition, Clinical Modification procedure codes 350.5 and 350.6 to identify patients undergoing transcatheter aortic valve replacement. Primary outcome of interest was in-hospital mortality. A 2-tailed P value <0.01 was considered to denote statistical significance for all analyses. We identified 42 189 patients who underwent transcatheter aortic valve replacement between the years 2011 and 2014. Of these, 62.1% (n=26 229) had no CKD/ESRD, 33.7% (n=14 252) had CKD, and 4% (n=1708) had ESRD. Patients with CKD or ESRD had greater in-hospital mortality, hospital length of stay, hemorrhage requiring transfusion, and permanent pacemaker implantation ( P <0.001). Conclusions— Patients with CKD and ESRD have increased in-hospital mortality and periprocedural adverse events with longer hospital length of stay, when compared with those without CKD