Incidence, Predictors, and Outcomes of Acute Kidney Injury in Patients Undergoing Transcatheter Aortic Valve Replacement-Reference-Cited by-同舟云学术

Incidence, Predictors, and Outcomes of Acute Kidney Injury in Patients Undergoing Transcatheter Aortic Valve Replacement

Published:2021-04 Issue:4 Volume:14 Page:
ISSN:1941-7640
Container-title:Circulation: Cardiovascular Interventions
language:en
Short-container-title:Circ: Cardiovascular Interventions

Author:

Julien Howard M.¹^ORCID,Stebbins Amanda²^ORCID,Vemulapalli Sreekanth²³^ORCID,Nathan Ashwin S.¹⁴⁵^ORCID,Eneanya Nwamaka D.⁶⁵,Groeneveld Peter⁴⁷⁵⁸^ORCID,Fiorilli Paul N.¹,Herrmann Howard C.¹^ORCID,Szeto Wilson Y.¹,Desai Nimesh D.¹⁴⁵,Anwaruddin Saif¹,Vora Amit⁹^ORCID,Shah Binita¹⁰^ORCID,Ng Vivian G.¹¹,Kumbhani Dharam J.¹²^ORCID,Giri Jay¹⁴³^ORCID

Affiliation:

1. Division of Cardiovascular Medicine (H.M.J., A.S.N., P.N.F., H.C.H., W.Y.S., N.D.D., S.A., J.G.), University of Pennsylvania, Philadelphia, PA.

2. Duke Clinical Research Institute, Durham, NC (A.S., S.V.).

3. Duke University Health System, Duke Heart Center, Division of Cardiology, Durham, NC (S.V., J.G.).

4. Penn Cardiovascular Outcomes, Quality, & Evaluative Research Center (A.S.N., P.G., N.D.D., J.G.), University of Pennsylvania, Philadelphia, PA.

5. Perelman School of Medicine and The Leonard Davis Institute of Health Economics (A.S.N., N.D.E., P.G., N.D.D.), University of Pennsylvania, Philadelphia, PA.

6. Renal-Electrolyte and Hypertension Division (N.D.E.), Palliative and Advanced Illness Research Center (N.D.E.), University of Pennsylvania, Philadelphia, PA.

7. Division of General Internal Medicine (P.G.), University of Pennsylvania, Philadelphia, PA.

8. Center for Health Equity Research and Promotion, Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, PA (P.G.).

9. University of Pittsburgh Medical Center-Pinnacle, Wormleysburg, PA (A.V.).

10. NYU School of Medicine (B.S.).

11. Columbia University Medical Center, New York, New York (V.G.N.).

12. Division of Cardiology, UT Southwestern Medical Center, Dallas (D.J.K.).

Abstract

Background: Reported rates of acute kidney injury (AKI) after transcatheter aortic valve replacement in small observational studies vary widely. Methods: Patients who underwent transcatheter aortic valve replacement in the United States between January 1, 2016 and June 30, 2018, were included. Patients without reported baseline or peak creatinine values and those who were previously on hemodialysis were excluded. AKI was defined using AKI Network criteria from stages 0 to 3. Logistic regression was used to assess patient and clinical factors associated with incident in-hospital AKI. Among patients with available data from the Center for Medicare and Medicaid Services administrative files, we compared 1-year mortality among patients with and without AKI. Results: Of 107 814 study patients, 11 566 (10.7%) experienced postprocedural AKI. Among patients who developed AKI, 10 220 (9.5%) experienced stage 1 AKI, 134 (0.1%) stage 2 AKI, and 1212 (1.1%) stage 3 AKI. Race, baseline comorbidities, clinical presentation, and procedural factors were associated with the development of stage 3 AKI. In Center for Medicare and Medicaid Services–linked analyses of 62 757 (58.2%) patients, those with AKI had higher adjusted hazard ratio for mortality at 1 year compared with patients who did not experience AKI (stage 1 AKI: adjusted hazard ratio, 2.7 [95% CI, 2.5–2.8], P <0.001; stage 2 AKI: adjusted hazard ratio, 10.4 [95% CI, 7.0–15.4], P <0.001; stage 3 AKI: adjusted hazard ratio, 7.0 [95% CI, 6.0–8.2], P <0.001). Conclusions: Using data from the Society of Thoracic Surgeons/American College of Cardiology National Cardiovascular Data Registry Transcatheter Valve Therapy Registry registry, we found that AKI is common after transcatheter aortic valve replacement, with over 10% of patients developing postprocedure AKI. Patients who developed stage 3 AKI had 7× higher adjusted 1-year mortality compared with patients who did not develop AKI.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Cardiology and Cardiovascular Medicine

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