Acute kidney injury following aortic valve replacement in patients without chronic kidney disease

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Moriyama , N , Laakso , T , Raivio , P , Dahlbacka , S , Kinnunen , E-M , Juvonen , T , Valtola , A , Husso , A , Jalava , M P , Ahvenvaara , T , Tauriainen , T , Piuhola , J , Lahtinen , A , Niemelä , M , Mäkikallio , T , Virtanen , M , Maaranen , P , Eskola , M , Savontaus , M , Airaksinen , J , Biancari , F & Laine , M 2021 , ' Acute kidney injury following aortic valve replacement in patients without chronic kidney disease ' , Canadian Journal of Cardiology , vol. 37 , no. 1 , pp. 37-46 . https://doi.org/10.1016/j.cjca.2020.03.015

Title: Acute kidney injury following aortic valve replacement in patients without chronic kidney disease
Author: Moriyama, Noriaki; Laakso, Teemu; Raivio, Peter; Dahlbacka, Sebastian; Kinnunen, Eeva-Maija; Juvonen, Tatu; Valtola, Antti; Husso, Annastiina; Jalava, Maina P.; Ahvenvaara, Tuomas; Tauriainen, Tuomas; Piuhola, Jarkko; Lahtinen, Asta; Niemelä, Matti; Mäkikallio, Timo; Virtanen, Marko; Maaranen, Pasi; Eskola, Markku; Savontaus, Mikko; Airaksinen, Juhani; Biancari, Fausto; Laine, Mika
Other contributor: University of Helsinki, Department of Medicine
University of Helsinki, HUS Heart and Lung Center
University of Helsinki, HUS Heart and Lung Center
University of Helsinki, Kardiologian yksikkö
University of Helsinki, Kardiologian yksikkö
University of Helsinki, Department of Surgery
University of Helsinki, Kardiologian yksikkö





Date: 2021-01
Language: eng
Number of pages: 10
Belongs to series: Canadian Journal of Cardiology
ISSN: 0828-282X
DOI: https://doi.org/10.1016/j.cjca.2020.03.015
URI: http://hdl.handle.net/10138/328204
Abstract: Background: The data on acute kidney injury (AKI) in patients without chronic kidney disease (CKD) after transcatheter aortic valve replacement (TAVR) are limited. The study sought to compare the incidence of AKI and its impact on 5-year mortality after TAVR and surgical aortic valve replacement (SAVR) in patients without CKD. Methods: This registry included data from 6463 consecutive patients who underwent TAVR or SAVR. CKD was defined as estimated glomerular filtration rate Results: The study included 4555 consecutive patients (TAVR, n = 1215 and SAVR, n = 3340) without CKD. Propensity-score matching identified 542 pairs. Patients who underwent TAVR had a significantly lower incidence of AKI in comparison to those who underwent SAVR (unmatched 4.7% vs 16.4%, P <0.001, multivariable analysis: odds ratio, 0.29, 95% confidence interval [CI], 0.20-0.41; matched 5.9% vs 19.0%, P <0.001). Patients with AKI had significantly increased 5-year mortality compared with those without AKI (unmatched 36.0% vs 19.1%, log-rank P <0.001; matched 36.3% vs 24.0%, log-rank P <0.001). The adjusted hazard ratios for 5-year mortality were 1.58 (95% CI, 1.20-2.08) for AKI grade 1, 3.27 (95% CI, 2.09-5.06) for grade 2, and 4.82 (95% CI, 2.93-8.04) for grade 3. Conclusions: TAVR in patients without CKD was associated with a significantly less frequent incidence of AKI compared with SAVR. AKI significantly increased the risk of 5-year mortality after either TAVR or SAVR, and increasing severity of AKI was incrementally associated with 5-year mortality.
Subject: 3121 General medicine, internal medicine and other clinical medicine
VASCULAR COMPLICATIONS
TRANSCATHETER
IMPLANTATION
RISK
STENOSIS
MORTALITY
SURGERY
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