Impact of Transcatheter Aortic Valve Implantation on Kidney Function
BACKGROUND: Chronic kidney disease (CKD) is frequently present in patients with aortic valve disease. Decreased kidney perfusion as a consequence of reduced cardiac output may contribute to renal dysfunction in this setting.
OBJECTIVE: Given the potential reversibility of kidney hypoperfusion after valve repair, this study aimed to analyze the impact of percutaneous transcatheter aortic valve implantation (TAVI) on kidney function.
METHODS: We performed a retrospective analysis of 233 consecutive patients who underwent TAVI in a single center between November 2008 and May 2016. We assessed three groups according to their baseline estimated glomerular filtration rate (eGFR) (mL/min/1.73 m2): Group 1 with eGFR ≥ 60; Group 2 with 30 ≤ eGFR < 60; and Group 3 with eGFR < 30. We analyzed the eGFR one month and one year after TAVI in these three groups, using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formula to calculate it.
RESULTS: Patients from Group 1 had a progressive decline in eGFR one year after the TAVI procedure (p < 0.001 vs. pre-TAVI). In Group 2 patients, the mean eGFR increased one month after TAVI and continued to grow after one year (p = 0.001 vs. pre-TAVI). The same occurred in Group 3, with the mean eGFR increasing from 24.4 ± 5.1 mL/min/1.73 m2 before TAVI to 38.4 ± 18.8 mL/min/1.73 m2 one year after TAVI (p = 0.012).
CONCLUSIONS: For patients with moderate-to-severe CKD, kidney function improved one year after the TAVI procedure. This outcome is probably due to better kidney perfusion post-procedure. We believe that when evaluating patients that might need TAVI, this 'reversibility of CKD effect' should be considered.
| Errataetall: |
CommentIn: Arq Bras Cardiol. 2019 Dec;113(6):1112-1113. - PMID 31800686 |
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2019 |
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| Erschienen: |
2019 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:113 |
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| Enthalten in: |
Arquivos brasileiros de cardiologia - 113(2019), 6 vom: 22. Dez., Seite 1104-1111 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Calça, Rita [VerfasserIn] |
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| Anmerkungen: |
Date Completed 19.05.2020 Date Revised 19.05.2020 published: Print CommentIn: Arq Bras Cardiol. 2019 Dec;113(6):1112-1113. - PMID 31800686 Citation Status MEDLINE |
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| doi: |
10.36660/abc.20180356 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM303540745 |
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| 500 | |a CommentIn: Arq Bras Cardiol. 2019 Dec;113(6):1112-1113. - PMID 31800686 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a BACKGROUND: Chronic kidney disease (CKD) is frequently present in patients with aortic valve disease. Decreased kidney perfusion as a consequence of reduced cardiac output may contribute to renal dysfunction in this setting | ||
| 520 | |a OBJECTIVE: Given the potential reversibility of kidney hypoperfusion after valve repair, this study aimed to analyze the impact of percutaneous transcatheter aortic valve implantation (TAVI) on kidney function | ||
| 520 | |a METHODS: We performed a retrospective analysis of 233 consecutive patients who underwent TAVI in a single center between November 2008 and May 2016. We assessed three groups according to their baseline estimated glomerular filtration rate (eGFR) (mL/min/1.73 m2): Group 1 with eGFR ≥ 60; Group 2 with 30 ≤ eGFR < 60; and Group 3 with eGFR < 30. We analyzed the eGFR one month and one year after TAVI in these three groups, using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formula to calculate it | ||
| 520 | |a RESULTS: Patients from Group 1 had a progressive decline in eGFR one year after the TAVI procedure (p < 0.001 vs. pre-TAVI). In Group 2 patients, the mean eGFR increased one month after TAVI and continued to grow after one year (p = 0.001 vs. pre-TAVI). The same occurred in Group 3, with the mean eGFR increasing from 24.4 ± 5.1 mL/min/1.73 m2 before TAVI to 38.4 ± 18.8 mL/min/1.73 m2 one year after TAVI (p = 0.012) | ||
| 520 | |a CONCLUSIONS: For patients with moderate-to-severe CKD, kidney function improved one year after the TAVI procedure. This outcome is probably due to better kidney perfusion post-procedure. We believe that when evaluating patients that might need TAVI, this 'reversibility of CKD effect' should be considered | ||
| 650 | 4 | |a Journal Article | |
| 700 | 1 | |a Teles, Rui C |e verfasserin |4 aut | |
| 700 | 1 | |a Branco, Patrícia |e verfasserin |4 aut | |
| 700 | 1 | |a Gaspar, Augusta |e verfasserin |4 aut | |
| 700 | 1 | |a Brito, João |e verfasserin |4 aut | |
| 700 | 1 | |a Nolasco, Tiago |e verfasserin |4 aut | |
| 700 | 1 | |a Almeida, Manuel D |e verfasserin |4 aut | |
| 700 | 1 | |a Neves, José P |e verfasserin |4 aut | |
| 700 | 1 | |a Mendes, Miguel |e verfasserin |4 aut | |
| 700 | 1 | |a Machado, Domingos S |e verfasserin |4 aut | |
| 700 | 1 | |a Weigert, André |e verfasserin |4 aut | |
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