The Risk of Acute Kidney Injury and Its Impact on 30-Day and Long-Term Mortality after Transcatheter Aortic Valve Implantation

Background. Transcatheter aortic valve implantation (TAVI) is widely used in high risk patients (pts) with aortic stenosis. Underlying chronic kidney disease implicates a high risk of postprocedural acute kidney injury (AKI).We analyzed its occurrence, impact on hospital stay, and mortality. Methods...

Verfasser: Gebauer, Katrin
Diller, Gerhard-Paul
Kaleschke, Gerrit Tobias
Kerckhoff, Gregor
Malyar, Nasser
Meyborg, Matthias John-Philipp
Reinecke, Holger
Baumgartner, Helmut
FB/Einrichtung:FB 05: Medizinische Fakultät
Dokumenttypen:Artikel
Medientypen:Text
Erscheinungsdatum:2012
Publikation in MIAMI:26.02.2013
Datum der letzten Änderung:28.01.2021
Angaben zur Ausgabe:[Electronic ed.]
Quelle:International Journal of Nephrology 2012 (2012) 483748
Fachgebiet (DDC):610: Medizin und Gesundheit
Lizenz:CC BY 2.5
Sprache:English
Anmerkungen:Finanziert durch den Open-Access-Publikationsfonds 2012/2013 der Deutschen Forschungsgemeinschaft (DFG) und der Westfälischen Wilhelms-Universität Münster (WWU Münster).
Format:PDF-Dokument
URN:urn:nbn:de:hbz:6-27379424985
Weitere Identifikatoren:DOI: 10.1155/2012/483748
Permalink:https://nbn-resolving.de/urn:nbn:de:hbz:6-27379424985
Onlinezugriff:483748.pdf

Background. Transcatheter aortic valve implantation (TAVI) is widely used in high risk patients (pts) with aortic stenosis. Underlying chronic kidney disease implicates a high risk of postprocedural acute kidney injury (AKI).We analyzed its occurrence, impact on hospital stay, and mortality. Methods. 150 consecutive pts underwent TAVI in our institution (mean age 81±7 years; logistic EuroSCORE 24±15%). AKI definition was a creatinine rise of 26.5 μmol/L or more within 48 hours postprocedural. Ten patients on chronic hemodialysis were excluded. Results. AKI occurred in 28 pts (20%). Baseline creatinine was higher in AKI pts (126.4±59.2 μmol/L versus 108.7±45.1 μmol/L, P = 0.09). Contrast media use was distributed evenly. Both, 30-day mortality (29% versus 7%, P < 0.0001) and long-term mortality (43% versus 18%, P < 0.0001) were higher; hospital stay was longer in AKI pts (20±12 versus 15±10 days, P = 0.03). Predicted renal failure calculated STS Score was similar (8.0±5.0% [AKI] versus 7.1±4.0% [non-AKI], P = 0.32) and estimated lower renal failure rates than observed. Conclusion. AKI remains a frequent complication with increased mortality in TAVI pts. Careful identification of risk factors and development of more suitable risk scores are essential.