Key result
Chronic kidney disease significantly increased the risk of 30-day all-cause mortality (RR 1.39) in patients undergoing transcatheter aortic valve replacement compared to those without CKD.
Why the study?
The impact of chronic kidney disease (CKD) and its different stages on prognosis in patients undergoing transcatheter aortic valve replacement (TAVR) remains unclear.
Does chronic kidney disease increase the risk of mortality and adverse events in patients undergoing TAVR?
Meta-Analysis (n=133,624)
Does chronic kidney disease increase the risk of mortality and adverse events in patients undergoing TAVR?
Relative Risk: 1.39 (95% CI 1.31–1.47)
p-value: p=<0.001
Chronic kidney disease is associated with a significantly increased risk of short- and long-term mortality, as well as periprocedural AKI and bleeding, in patients undergoing TAVR.
PURPOSE: The impact of chronic kidney disease (CKD) on the prognosis of transcatheter aortic valve replacement (TAVR) remains unclear. The purpose of this meta-analysis was to assess the impact of CKD and different stages of CKD on prognosis in patients undergoing TAVR. METHODS: As of June 2020, we performed a comprehensive literature search on relevant studies using PubMed, Embase, Cochrane Library, and Web of Science. Subsequently, we pooled the risk ratio (RR) of individual studies via random effects to analyze heterogeneity, quality assessment, and publication bias. RESULTS: A total of 20 studies, involving 133624 patients, were eligible for analysis. Patients with CKD had higher all-cause mortality at 30 days (RR: 1.39, 95% confidence interval [CI]: 1.31-1.47, P <0.001), 1 year (RR: 1.36, 95% CI: 1.24-1.49, P <0.001), and 2 years (RR: 1.2, 95% CI: 1.05-1.38, P = 0.009) of follow-up. Moreover, they also had higher acute kidney injury (AKI) (RR: 1.38, 95% CI: 1.16-1.63, P <0.001) and bleeding (RR: 1.33, 95% CI: 1.18-1.50, P <0.001) at 30 days. CKD3 alone also increased all-cause mortality at follow-ups. Risk of all-cause mortality increased with severity of CKD for stages 3, 4, and 5 at follow-up. CONCLUSION: Patients with CKD are at an increased risk of all-cause mortality, AKI, and bleeding events after TAVR. Moreover, the mortality risk rises with increasing severity of CKD.
No takes yet. Share an insight, caveat, or question.
Wang et al. (2021) conducted a meta-analysis in Aortic stenosis (n=133,624). Chronic kidney disease vs. No chronic kidney disease was evaluated on All-cause mortality at 30 days (RR 1.39, 95% CI 1.31-1.47, p=<0.001). Chronic kidney disease significantly increased the risk of 30-day all-cause mortality (RR 1.39) in patients undergoing transcatheter aortic valve replacement compared to those without CKD.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: