Journal Article

Acute kidney injury and acute kidney recovery following Transcatheter Aortic Valve Replacement

Reydel, Antje, Trimaille, Antonin, Kibler, Marion, Peillex, Marilou, Marchandot, Benjamin, Matsushita, Kensuke, Jesel, Laurence, Heger, Joe, Carmona, Adrien, Morel, Olivier, Hess, Sebastien, Petit-Eisenmann, Hélène, Ohlmann, Patrick, Trinh, Annie, Prinz, Eric

2021

Overview

Acute kidney injury (AKI) is associated with a dismal prognosis in Transcatheter Aortic Valve replacement (TAVR). Acute kidney recovery (AKR), a phenomenon reverse to AKI has recently been associated with better outcomes. Between November 2012 to May 2018, we explored consecutive patients referred to our Heart Valve Center for TAVR. AKI was defined according to the VARC-2 definition. Mirroring the VARC-2 definition of AKI, AKR was defined as a decrease in serum creatinine ([greater than or equal to]50%) or [greater than or equal to]25% improvement in GFR up to 72 hours after TAVR. AKI and AKR were respectively observed in 8.3 and 15.7% of the 574 patients included. AKI and AKR patients were associated to more advanced kidney disease at baseline. At a median follow-up of 608 days (range 355-893), AKI and AKR patients experienced an increased cardiovascular mortality compared to unchanged renal function patients (14.6% and 17.8% respectively, vs. 8.1%, CI 95%, p<0.022). Chronic kidney disease, (HR: 3.9; 95% CI 1.7-9.2; p < 0.001) was the strongest independent factor associated with AKI similarly to baseline creatinine level (HR: 1; 95% CI 1 to 1.1 p < 0.001) for AKR. 72-hours post procedural AKR (HR: 2.26; 95% CI 1.14 to 4.88; p = 0.021) was the strongest independent predictor of CV mortality. Both AKR and AKI negatively impact long term clinical outcomes of patients undergoing TAVR.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Aorta / Aortic valve / Auroral kilometric radiation / Blood / Cardiology and cardiovascular system / Cardiovascular diseases / Care and treatment / Chronic kidney failure / Complications and side effects / Creatinine / Heart valve replacement / Heart valves / Hospitals / Human health and pathology / Kidney diseases / Kidneys / Life Sciences / Medical research / Medicine / Mortality / Multivariate analysis / Patient outcomes / Patients / Recovery / Renal function / Rheumatic heart disease / Surgery / Urology and Nephrology / Variables