In:
PLOS ONE, Public Library of Science (PLoS), Vol. 16, No. 8 ( 2021-8-10), p. e0255806-
Abstract:
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.
Type of Medium:
Online Resource
ISSN:
1932-6203
DOI:
10.1371/journal.pone.0255806
DOI:
10.1371/journal.pone.0255806.g001
DOI:
10.1371/journal.pone.0255806.g002
DOI:
10.1371/journal.pone.0255806.g003
DOI:
10.1371/journal.pone.0255806.t001
DOI:
10.1371/journal.pone.0255806.t002
DOI:
10.1371/journal.pone.0255806.t003
DOI:
10.1371/journal.pone.0255806.t004
DOI:
10.1371/journal.pone.0255806.t005
DOI:
10.1371/journal.pone.0255806.t006
DOI:
10.1371/journal.pone.0255806.t007
DOI:
10.1371/journal.pone.0255806.s001
DOI:
10.1371/journal.pone.0255806.s002
DOI:
10.1371/journal.pone.0255806.r001
DOI:
10.1371/journal.pone.0255806.r002
DOI:
10.1371/journal.pone.0255806.r003
DOI:
10.1371/journal.pone.0255806.r004
Language:
English
Publisher:
Public Library of Science (PLoS)
Publication Date:
2021
detail.hit.zdb_id:
2267670-3