Acute kidney injury occurred in 28% of TAVR patients and was independently associated with a transapical approach (OR 2.81; 95% CI 1.72-4.65) and need for an intra-aortic balloon pump.
Cohort (n=386)
No
Acute kidney injury is a common complication following TAVR (28% incidence) that is strongly associated with transapical access, need for circulatory support, and lower baseline renal function, and it significantly increases short-term mortality.
Abstract Aim This study aimed to determine the incidence and risk factors of acute kidney injury (AKI) following transcatheter aortic valve replacement (TAVR). Methods We included all adult patients undergoing TAVR for aortic stenosis from 1 January 2008 to 30 June 2014 at a tertiary referral hospital. AKI was defined based on Kidney Disease: Improving Global Outcomes criteria. We performed a multivariate logistic regression to identify factors associated with post‐procedural AKI occurrence. Results Three hundred eighty‐six patients met the inclusion criteria, of which 106 (28%) developed AKI. In multivariate analysis, AKI development was independently associated with a transapical approach (odds ratio (OR), 2.81; 95% confidence interval (CI), 1.72–4.65 compared with transfemoral approach) and the need for an intra‐aortic balloon pump (OR, 9.11; 95% CI, 1.77–68.29). Higher baseline renal function (OR, 0.78 per 10 mL/min per 1.73 m 2 increment in glomerular filtration rate; 95% CI, 0.68–0.87) was significantly associated with a decreased risk of AKI. After adjustment for the Society of Thoracic Surgeons' risk score, post‐procedural AKI development remained significantly associated with an increased in‐hospital (OR, 4.74; 95% CI, 1.39–18.48) and 6‐month mortality (OR, 4.66; 95% CI, 2.32–9.63). Conclusion In a cohort of patients undergoing TAVR for aortic stenosis, AKI commonly occurred and was significantly associated with increased mortality. Baseline renal function, procedure approach and the need for circulatory support were important predictive factors for post‐procedural AKI occurrence.
Thongprayoon et al. (2015) conducted a cohort in Aortic stenosis (n=386). Transcatheter aortic valve replacement (TAVR) was evaluated on Acute kidney injury (AKI). Acute kidney injury occurred in 28% of TAVR patients and was independently associated with a transapical approach (OR 2.81; 95% CI 1.72-4.65) and need for an intra-aortic balloon pump.
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