Acute kidney injury and acute kidney recovery following Transcatheter Aortic Valve Replacement

Archive ouverte

Peillex, Marilou | Marchandot, Benjamin | Matsushita, Kensuke | Prinz, Eric | Hess, Sebastien | Reydel, Antje | Kibler, Marion | Carmona, Adrien | Trimaille, Antonin | Heger, Joe | Petit-Eisenmann, Hélène | Trinh, Annie | Jesel, Laurence | Ohlmann, Patrick | Morel, Olivier

Edité par CCSD ; Public Library of Science -

International audience. Background Acute kidney injury (AKI) is associated with a dismal prognosis in Transcatheter Aortic Valve replacement (TAVR). Acute kidney recovery (AKR), a phenomenon reverse to AKI has recently been associated with better outcomes.Methods: Between November 2012 to May 2018, we explored consecutive patients referred to our Heart Valve Center for TAVR. AKI was defined according to the VARC-2 definition. Mirroring the VARC-2 definition of AKI, AKR was defined as a decrease in serum creatinine (≥50%) or ≥25% improvement in GFR up to 72 hours after TAVR.Results AKI and AKR were respectively observed in 8.3 and 15.7% of the 574 patients included. AKI and AKR patients were associated to more advanced kidney disease at baseline. At a median follow-up of 608 days (range 355-893), AKI and AKR patients experienced an increased cardiovascular mortality compared to unchanged renal function patients (14.6% and 17.8% respectively, vs. 8.1%, CI 95%, p<0.022). Chronic kidney disease, (HR: 3.9; 95% CI 1.7-9.2; p < 0.001) was the strongest independent factor associated with AKI similarly to baseline creatinine level (HR: 1; 95% CI 1 to 1.1 p < 0.001) for AKR. 72-hours post procedural AKR (HR: 2.26; 95% CI 1.14 to 4.88; p = 0.021) was the strongest independent predictor of CV mortality.Conclusions: Both AKR and AKI negatively impact long term clinical outcomes of patients undergoing TAVR.

• Description
• Sujet/Public
• Outil
• Outil d'anticipation
• Mémoire et thèse
• Gestion