Incidence of Acute Kidney Injury in Patients with Chronic Renal Insufficiency: Transcatheter versus Surgical Aortic Valve Replacement

• Published in: Journal of interventional cardiology 2019-01, Vol.2019 (2019), p.1-6
• Main Authors: Hartman, Alan, Yu, Pey-Jen, Esposito, Rick, Berg, Jacinda A., Maurer, Greg, Rutkin, Bruce, Kohn, Nina, Cassiere, Hugh, Lin, Dishen, Catalano, Michael, Jahn, Jaclyn
• Format: Article
• Language: English
• Subjects: Acute Kidney Injury - epidemiology; Acute Kidney Injury - etiology; Acute Kidney Injury - therapy; Aged; Aged, 80 and over; Aortic stenosis; Aortic valve; Aortic valve stenosis; Aortic Valve Stenosis - complications; Aortic Valve Stenosis - surgery; Body mass index; Cardiology; Care and treatment; Chronic kidney failure; Chronic obstructive pulmonary disease; Consortia; Coronary artery; Coronary artery bypass; Coronary Artery Bypass - adverse effects; Critical care; Diabetes; Epidermal growth factor receptors; Female; Gender; Heart failure; Heart surgery; Heart Valve Prosthesis Implantation - adverse effects; Heart Valve Prosthesis Implantation - methods; Hemodialysis; Humans; Hypertension; Incidence; Kidney diseases; Male; Medical research; Medicine, Experimental; Mortality; Outcome and Process Assessment, Health Care; Patients; Postoperative Complications - epidemiology; Postoperative Complications - etiology; Postoperative Complications - therapy; Renal Dialysis - statistics & numerical data; Renal insufficiency; Renal Insufficiency, Chronic - complications; Review boards; Stenosis; Surgeons; Transcatheter Aortic Valve Replacement - adverse effects; Transcatheter Aortic Valve Replacement - methods; United States
• ISSN: 0896-4327; 1540-8183
• DOI: 10.1155/2019/9780415

Objectives. 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. The incidence of AKI in patients with preexisting renal insufficiency undergoing TAVR versus SAVR is not well described. 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 m2. The incidence of postoperative AKI was compared using the RIFLE classification system for acute kidney injury. 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