Change in Kidney Function and 2-Year Mortality After Transcatheter Aortic Valve Replacement

• DOI: 10.1001/jamanetworkopen.2021.3296
• Publication Date: 2021-03-26T15:30:49Z
• Authors: Guy Witberg; Tali Steinmetz; Uri Landes; Rotem Pistiner Hanit; Hefziba Green; Shira Goldman; Hana Vaknin-Assa; Pablo Codner; Leor Perl; Benaya Rozen-Zvi; Ran Kornowski
• Keywords: Valve replacement; valvular heart disease

<h3>Importance</h3> Chronic kidney disease (CKD) is prevalent in the population of patients undergoing transcatheter aortic valve replacement (TAVR). Data on association TAVR with function are scarce, as data relationship between changes after and mortality. <h3>Objective</h3> To describe (both periprocedural at steady state) to explore midterm <h3>Design, Setting, Participants</h3> This single-center, retrospective cohort study was conducted a public, tertiary academic medical center, which serves regional referral center for valvular heart interventions. Consecutive cases from November 5, 2008, December 31, 2019, were included study, available baseline post-TAVR function. <h3>Exposures</h3> Steady state (1 month) change TAVR. Significant improvement or deterioration renal defined greater than equal 10% estimated glomerular filtration rate (eGFR). <h3>Main Outcomes Measures</h3> Overall mortality 2-year follow-up. <h3>Results</h3> A total 894 (mean [SD] age, 82.2 [7.1] years; 452 women ([51.2%]) evaluated. 362 (40.5%) treated 2017 348 (38.9%) 2013 2016, 184 (20.5%) 2008 2012. Patients had mean (SD) Society Thoracic Surgeons (STS) score 5.2% (4.0%) eGFR 65.1 (23.1) mL/min/1.73 m². Acute injury occurred 115 (11.1%) by 48 hours, whom 73 (63.5%) resolved discharge. One month TAVR, improved least 329 (36.8%) deteriorated 233 (26.1%). Overall, CKD stage remained stable 720 (80.6%), only 5 (0.97%) progressed 1 associated hazard ratio 2.16 (95% CI, 1.24-5.24;<i>P</i> = .04) who showed status resolution (eGFR &gt;60 m²after TAVR) similar those 60 m²and vice versa. Factors lower STS score, higher left ventricular ejection fraction, eGFR, no acute discharge admission, contrast-eGFR ratio. <h3>Conclusions Relevance</h3> In this outcomes reassuring; 80% procedure. Improvement mortality, whereas increased Our suggest that cardiorenal syndrome possible cause need there potential both cardiac