Incidence of Acute Kidney Injury in Patients with Chronic Renal Insufficiency: Transcatheter versus Surgical Aortic Valve Replacement.
Acute Kidney Injury
/ epidemiology
Aged
Aged, 80 and over
Aortic Valve Stenosis
/ complications
Coronary Artery Bypass
/ adverse effects
Female
Heart Valve Prosthesis Implantation
/ adverse effects
Humans
Incidence
Male
Outcome and Process Assessment, Health Care
Postoperative Complications
/ epidemiology
Renal Dialysis
/ statistics & numerical data
Renal Insufficiency, Chronic
/ complications
Transcatheter Aortic Valve Replacement
/ adverse effects
United States
Journal
Journal of interventional cardiology
ISSN: 1540-8183
Titre abrégé: J Interv Cardiol
Pays: United States
ID NLM: 8907826
Informations de publication
Date de publication:
2019
2019
Historique:
received:
12
02
2019
accepted:
14
04
2019
entrez:
28
11
2019
pubmed:
28
11
2019
medline:
29
2
2020
Statut:
epublish
Résumé
The objective of this study is to determine incidence of acute kidney injury (AKI) associated with transcatheter aortic valve replacement (TAVR) versus surgical aortic valve replacement (SAVR) in patients with preexisting chronic kidney disease. The incidence of AKI in patients with preexisting renal insufficiency undergoing TAVR versus SAVR is not well described. All patients with preexisting chronic kidney disease who underwent SAVR for aortic stenosis with or without concomitant coronary artery bypass grafting or TAVR from 5/2008 to 6/2017. Patients requiring preoperative hemodialysis were excluded. Chronic kidney disease was defined as an estimated glomerular filtrate rate (eGFR) of < 60 mL/min/1.73 m A total of 406 SAVR patients and 407 TAVR patients were included in this study. TAVR patients were older and had lower preoperative eGFR as compared to SAVR patients. Covariate adjustment using propensity score between the two groups showed that SAVR patients were more likely to have a more severe degree of postoperative AKI as compared to TAVR patients (OR = 4.75; 95% CI: 3.15, 7.17; p <.001). SAVR patients were more likely to require dialysis postoperatively as compared to TAVR patients (OR = 4.55; 95% CI: 1.29, 15.99; p <.018). In patients with preexisting chronic kidney disease, TAVR was associated with significantly less AKI as compared to SAVR.
Sections du résumé
OBJECTIVES
OBJECTIVE
The objective of this study is to determine incidence of acute kidney injury (AKI) associated with transcatheter aortic valve replacement (TAVR) versus surgical aortic valve replacement (SAVR) in patients with preexisting chronic kidney disease.
BACKGROUND
BACKGROUND
The incidence of AKI in patients with preexisting renal insufficiency undergoing TAVR versus SAVR is not well described.
METHODS
METHODS
All patients with preexisting chronic kidney disease who underwent SAVR for aortic stenosis with or without concomitant coronary artery bypass grafting or TAVR from 5/2008 to 6/2017. Patients requiring preoperative hemodialysis were excluded. Chronic kidney disease was defined as an estimated glomerular filtrate rate (eGFR) of < 60 mL/min/1.73 m
RESULTS
RESULTS
A total of 406 SAVR patients and 407 TAVR patients were included in this study. TAVR patients were older and had lower preoperative eGFR as compared to SAVR patients. Covariate adjustment using propensity score between the two groups showed that SAVR patients were more likely to have a more severe degree of postoperative AKI as compared to TAVR patients (OR = 4.75; 95% CI: 3.15, 7.17; p <.001). SAVR patients were more likely to require dialysis postoperatively as compared to TAVR patients (OR = 4.55; 95% CI: 1.29, 15.99; p <.018).
CONCLUSION
CONCLUSIONS
In patients with preexisting chronic kidney disease, TAVR was associated with significantly less AKI as compared to SAVR.
Identifiants
pubmed: 31772554
doi: 10.1155/2019/9780415
pmc: PMC6739800
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
9780415Informations de copyright
Copyright © 2019 Michael Catalano et al.
Déclaration de conflit d'intérêts
Bruce Rutkin is a consultant for Medtronic. No other authors have any conflicts of interest to disclose.
Références
J Card Surg. 2016 Jul;31(7):416-22
pubmed: 27212701
Expert Rev Cardiovasc Ther. 2015 Mar;13(3):301-16
pubmed: 25592763
Eur Heart J. 2010 Apr;31(7):865-74
pubmed: 20037180
Clin Cardiol. 2017 Nov;40(11):1156-1162
pubmed: 29166543
Circulation. 2009 Feb 3;119(4):495-502
pubmed: 19153273
Heart Surg Forum. 2012 Feb;15(1):E4-8
pubmed: 22360904
Circulation. 2007 Sep 11;116(11 Suppl):I139-43
pubmed: 17846294
Cardiovasc Revasc Med. 2017 Oct - Nov;18(7):507-511
pubmed: 29054156
J Card Surg. 2017 Sep;32(9):550-555
pubmed: 28833503
Catheter Cardiovasc Interv. 2016 Jun;87(7):1314-21
pubmed: 26946240
Crit Care. 2011;15(1):R16
pubmed: 21232094
J Am Coll Cardiol. 2012 Oct 9;60(15):1438-54
pubmed: 23036636
Clin Cardiol. 2017 Dec;40(12):1357-1362
pubmed: 29251358
Kidney Int. 2007 Sep;72(5):624-31
pubmed: 17622275
Am Heart J. 2011 Apr;161(4):735-9
pubmed: 21473973
J Am Soc Nephrol. 2016 Jun;27(6):1854-60
pubmed: 26487562
Arch Intern Med. 2003 Feb 10;163(3):356-60
pubmed: 12578517
Eur Heart J. 1987 May;8(5):471-83
pubmed: 3609042
Ann Intern Med. 2009 May 5;150(9):604-12
pubmed: 19414839
Ann Thorac Surg. 2016 Oct;102(4):1172-80
pubmed: 27592092
Crit Care Med. 2008 Apr;36(4):1129-37
pubmed: 18379238
J Thorac Cardiovasc Surg. 2013 Dec;146(6):1399-406; discussion 13406-7
pubmed: 24075566
Thorac Cardiovasc Surg. 2012 Jul;60(5):335-42
pubmed: 22547302
Am J Cardiol. 2013 Dec 1;112(11):1807-11
pubmed: 24012024
Crit Care. 2004 Aug;8(4):R204-12
pubmed: 15312219
Am Heart J. 2012 Jun;163(6):1031-6
pubmed: 22709757
Heart. 2013 Mar;99(6):396-400
pubmed: 22942293
Ann Thorac Surg. 2016 Aug;102(2):540-7
pubmed: 27130249
N Engl J Med. 2011 Jun 9;364(23):2187-98
pubmed: 21639811
Crit Care. 2009;13(6):429
pubmed: 20067601
Ann Thorac Surg. 2011 Jun;91(6):1798-806; discussion 1806-7
pubmed: 21536247