Potential of transcatheter aortic valve replacement to improve post-procedure renal function
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Citações na Scopus
9
Tipo de produção
article
Data de publicação
2017
Título da Revista
ISSN da Revista
Título do Volume
Editora
ELSEVIER INC
Citação
CARDIOVASCULAR REVASCULARIZATION MEDICINE, v.18, n.7, p.507-511, 2017
Resumo
Background: Baseline comorbidities including renal dysfunction are frequently found in patients treated with transcatheter aortic valve replacement (TAVR) and may increase the risks of acute kidney injury (AKI), although some of them may actually improve renal function. We aimed to evaluate the potential of TAVR to acutely improve post-procedure renal function. Methods: This is a prospective single-center registry of consecutive patients with severe symptomatic aortic stenosis treated by transfemoral TAVR. Creatinine levels were determined at baseline and daily until hospital discharge. AKI was defined according to VARC-2 criteria. Patients who had improvement of creatinine levels >25% were classified as having TAVR induced renal function improvement (TIRFI). Results: A total of 69 patients undergoing TAVR were included, with a mean age of 83.0 +/- 7.4 years, being 24.6% diabetics, with a median STS score of 9.2 (5.1-21.6). Using the VARC-2 criteria, the majority of patients (64.6%) did not have renal impairment, while AKI was detected in 35.4% of the patients. Importantly, in those with prior severe renal dysfunction (clearance <30 mL/min/1.73 m(2)) or diabetes, AKI reached up to 50% and 56.3% of the patients, respectively. Conversely, acute kidney recovery (TIRFI) occurred in 12 patients (18.5%) being >50% in 1 patient (1.5%), and at hospital discharge the majority of the patients (88.6%) left the hospital in their original or better renal function categories. Conclusion: Despite multiple comorbidities in a selected TAVR-population and the use of contrast media, TAVR did not impair renal function in a majority of patients, with a significant proportion of them rather having acute renal function improvement.
Palavras-chave
Transcatheter aortic valve implantation, Renal improvement, Acute kidney injury, Renal failure
Referências
- Allende R, 2014, EUR HEART J, V35, P2685, DOI 10.1093/eurheartj/ehu175
- Aregger F, 2009, NEPHROL DIAL TRANSPL, V24, P2175, DOI 10.1093/ndt/gfp036
- Bagur R, 2010, EUR HEART J, V31, P865, DOI 10.1093/eurheartj/ehp552
- Barbanti M, 2015, JACC-CARDIOVASC INTE, V8, P1595, DOI 10.1016/j.jcin.2015.07.012
- Finn WF, 2006, NEPHROL DIAL TRANSPL, V21, pi2, DOI 10.1093/NDT/GFL213
- Gruberg L, 2000, J AM COLL CARDIOL, V36, P1542, DOI 10.1016/S0735-1097(00)00917-7
- Hahn RT, 2013, J AM COLL CARDIOL, V61, P2514, DOI 10.1016/j.jacc.2013.02.087
- Kappetein AP, 2012, J AM COLL CARDIOL, V60, P1438, DOI 10.1016/j.jacc.2012.09.001
- Keles T, 2013, J GERIATR CARDIOL, V10, P317, DOI 10.3969/j.issn.1671-5411.2013.04.010
- Khatri PJ, 2013, ANN INTERN MED, V158, P35, DOI 10.7326/0003-4819-158-1-201301010-00007
- Le Ven F, 2013, J AM COLL CARDIOL, V62, P782, DOI 10.1016/j.jacc.2013.05.044
- Leon MB, 2016, N ENGL J MED
- Levey AS, 2005, KIDNEY INT, V67, P2089, DOI 10.1111/j.1523-1755.2005.00365.x
- Mangano CM, 1998, ANN INTERN MED, V128, P194
- Mehran R, 2006, KIDNEY INT, V69, pS11, DOI 10.1038/sj.ki.5000368
- Mehran R, 2004, J AM COLL CARDIOL, V44, P1393, DOI 10.1016/j.jacc.2004.06.068
- Mehta RL, 2007, CRIT CARE, V11, DOI 10.1186/cc5713
- Nuis RJ, 2012, CIRC-CARDIOVASC INTE, V5, P680, DOI 10.1161/CIRCINTERVENTIONS.112.971291
- Ribeiro HB, 2014, PROG CARDIOVASC DIS, V56, P583, DOI 10.1016/j.pcad.2014.02.001
- Rodes-Cabau J, 2012, NAT REV CARDIOL, V9, P15, DOI 10.1038/nrcardio.2011.164
- Tepel M, 2006, CIRCULATION, V113, P1799, DOI 10.1161/CIRCULATIONAHA.105.595090