Key result
Following TAVR, patients with baseline CKD had a significantly attenuated decline in eGFR compared to those without CKD (difference 3.19 mL/min/1.73 m2/year; 95% CI, 1.44 to 4.94; p<0.001).
Why the study?
The effect of transcatheter aortic valve replacement on long-term kidney function trajectories in patients with and without chronic kidney disease remains unclear.
Does TAVR alter kidney function trajectories differently in patients with severe aortic stenosis with and without chronic kidney disease?
Cohort (n=314)
No
Does TAVR alter kidney function trajectories differently in patients with severe aortic stenosis with and without chronic kidney disease?
Mean Difference: 3.19 (95% CI 1.44–4.94)
Absolute Event Rate: -0.83% vs -4.02%
p-value: p=< 0.001
TAVR is associated with an attenuation of eGFR decline in patients with severe aortic stenosis and baseline CKD, suggesting potential renal benefits from hemodynamic improvement.
Post-TAVR kidney function trajectories in severe AS are hypothesis-generating; leaves open long-term renal effects in CKD.
Background/Objectives: Transcatheter aortic valve replacement (TAVR) may improve systemic hemodynamics and kidney perfusion; however, its effect on long-term kidney function remains unclear. We evaluated kidney function trajectories before and after TAVR in patients with and without chronic kidney disease (CKD). Methods: This single-center retrospective cohort study included patients with severe aortic stenosis (AS) who underwent TAVR between June 2016 and December 2024. Overall, 314 eligible patients were classified by baseline estimated glomerular filtration rate (eGFR) as without CKD (≥60 mL/min/1.73 m2) or with CKD (<60 mL/min/1.73 m2). Linear mixed-effects models estimated pre- and post-TAVR eGFR slopes, which were compared between groups after covariate adjustment. Results: Median follow-up was 2.0 years. Adjusted pre-TAVR eGFR slopes were −2.11 (95% confidence interval [CI], −3.34 to −0.89) mL/min/1.73 m2/year in patients without CKD and −2.83 (95% CI, −3.65 to −2.01) mL/min/1.73 m2/year in patients with CKD. The post-TAVR slopes were −4.02 (95% CI, −5.68 to −2.35) mL/min/1.73 m2/year in patients without CKD and −0.83 (95% CI, −2.04 to 0.39) mL/min/1.73 m2/year in patients with CKD, with a significant group difference of 3.19 (95% CI, 1.44 to 4.94) mL/min/1.73 m2/year (p < 0.001). In patients with CKD, the post-TAVR slope improved relative to the pre-TAVR slope by 2.01 (95% CI, 0.51 to 3.50) mL/min/1.73 m2/year (p < 0.01), whereas no significant change was observed in those without CKD. Conclusions: eGFR decline after TAVR was attenuated in patients with CKD compared with those without CKD, suggesting that kidney function may be preserved through hemodynamic improvement following TAVR.
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Sakuma et al. (2026) conducted a cohort in severe aortic stenosis (n=314). Chronic kidney disease (baseline eGFR <60 mL/min/1.73 m2) vs. Without chronic kidney disease (baseline eGFR ≥60 mL/min/1.73 m2) was evaluated on post-TAVR eGFR slope (mL/min/1.73 m2/year) (MD 3.19, 95% CI 1.44 to 4.94, p=< 0.001). Following TAVR, patients with baseline CKD had a significantly attenuated decline in eGFR compared to those without CKD (difference 3.19 mL/min/1.73 m2/year; 95% CI, 1.44 to 4.94; p<0.001).
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