Late kidney injury after transcatheter aortic valve replacement.

Abstract

BACKGROUND:

Information on early to late-phase kidney damage in patients who underwent transcatheter aortic valve replacement (TAVR) is scarce. We aimed to identify the predictive factors for late kidney injury (LKI) at 1-year and patient prognosis beyond 1-year after TAVR.

METHODS:

We retrospectively reviewed 1,705 patients' data from the Japanese TAVR multicenter registry. Acute kidney injury (AKI) and LKI, defined as an increase of at least 0.3 mg/dL in creatinine level, a relative 50% decrease in kidney function from baseline to 48 hours and 1-year, were evaluated. The patients were categorized into the 4 groups as AKI-/LKI- (n = 1.362), AKI+/LKI- (n = 95), AKI-/LKI+ (n = 199), and AKI+/LKI+ (n = 46).

RESULTS:

The cumulative 3-year mortality rates were significantly increased across the four groups (12.5%, 15.8%, 24.6%, 25.8%, P < .001). Multivariate analysis revealed that chronic kidney disease, coronary artery disease, periprocedural AKI, and heart failure-related re-admission within 1-year were significantly associated with LKI. The Cox regression analysis revealed that AKI-/LKI+ and AKI+/LKI+ were independent predictors of increased late mortality beyond 1-year after TAVR (P = .001 and P = .01).

CONCLUSIONS:

LKI was influenced by adverse cardio-renal events and was associated with increased risks of late mortality beyond 1-year after TAVR.

• Authors: Yuya Adachi, Masanori Yamamoto, Tetsuro Shimura, Ryo Yamaguchi, Ai Kagase, Takahiro Tokuda, Satoshi Tsujimoto, Yutaka Koyama, Toshiaki Otsuka, Fumiaki Yashima, Norio Tada, Toru Naganuma, Motoharu Araki, Futoshi Yamanaka, Shinichi Shirai, Kazuki Mizutani, Minoru Tabata, Hiroshi Ueno, Kensuke Takagi, Yusuke Watanabe, Kentaro Hayashida, OCEAN-TAVI Investigators
• Journal: American heart journal (Am Heart J) Vol. 234 Pg. 122-130 (04 2021) ISSN: 1097-6744 [Electronic] United States
• PMID: 33454371 (Publication Type: Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2021 Elsevier Inc. All rights reserved.

Chemical References

• Creatinine

Topics

• Acute Kidney Injury (blood, etiology, mortality)
• Aged, 80 and over
• Coronary Artery Disease (complications)
• Creatinine (blood)
• Heart Failure (complications)
• Humans
• Kidney (injuries)
• Multivariate Analysis
• Patient Readmission
• Postoperative Complications (blood, etiology, mortality)
• Prognosis
• Renal Insufficiency, Chronic (complications)
• Retrospective Studies
• Time Factors
• Transcatheter Aortic Valve Replacement (adverse effects)