Key result
Higher contrast volume to eGFR ratio during TAVR predicts AKI.
Why the study?
The role of contrast volume in the context of baseline renal function as a predictor of acute kidney injury is less well described in patients undergoing TAVR.
Does the ratio of contrast volume to estimated glomerular filtration rate predict acute kidney injury in patients undergoing transcatheter aortic valve replacement?
Cohort
Yes
Does the ratio of contrast volume to estimated glomerular filtration rate predict acute kidney injury in patients undergoing transcatheter aortic valve replacement?
The ratio of contrast volume to eGFR is a robust predictor of acute kidney injury following TAVR, suggesting thresholds of >2× and >3× eGFR should be incorporated into procedural planning.
Answers are grounded in this paper and cite their sources.
May support contrast minimization in TAVR to lower AKI risk; leaves open whether ratio-guided interventions improve outcomes.
Background: Acute kidney injury (AKI) after contrast-guided interventions is associated with adverse outcomes, but the role of contrast in the context of renal function is less well described for patients undergoing transcatheter aortic valve replacement (TAVR). Methods: Patients from the Michigan TAVR registry between January 2016 and December 2019 were included. AKI was defined using Valve Academic Research Consortium 2 definitions. An integer cut point for the ratio of contrast volume (CV) to renal function (estimated glomerular filtration rate [eGFR]) as a predictor of AKI was calculated. Results: < .0001, 95% CI = 1.38-2.03). Conclusions: CV in the context of renal function administrated during TAVR is a robust tool to predict AKI. AKI after TAVR is associated with an increased risk of mortality. Incorporation of thresholds of >2× and > 3× eGFR into procedural planning should be considered as a quality initiative.
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Gualano et al. (2022) conducted a cohort in Transcatheter aortic valve replacement (TAVR). Ratio of contrast volume to estimated glomerular filtration rate (CV/eGFR) was evaluated on Acute kidney injury (AKI) (95% CI 1.38-2.03, p=<0.0001). The ratio of contrast volume to estimated glomerular filtration rate during TAVR predicted acute kidney injury.
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