Influence of Preoperative Serum Creatinine Level and Intraoperative Volume of Contrast Medium on the Risk of Acute Kidney Injury After Transfemoral Transcatheter Aortic Valve Implantation: a Retrospective Observational Study

Overview

Journal BMC Res Notes

Publisher Biomed Central

Specialties Biology
General Medicine

Date 2019 Aug 7

PMID 31383003

Citations 2

Authors

Daisuke Miura

Yasutaka Yamada

Shinichiro Kusaba

Eijiro Nogami

Junji Yunoki

Yoshiko Sakamoto

Yutaka Hikichi

Koichi Node

Yoshiro Sakaguchi

Affiliations

Soon will be listed here.

Abstract

Objective: This study aimed to determine if contrast medium volume (CMV) is a risk factor for acute kidney injury (AKI) during transcatheter aortic valve implantation (TAVI) via a transfemoral approach performed without major complications. All TAVI procedures performed at our institution between March 2014 and March 2018 were retrospectively reviewed. AKI was diagnosed using the Acute Kidney Injury Network classification based on the Valve Academic Research Consortium-2 definition. Procedures performed via a transapical approach and those in which circulatory dynamics failed intraoperatively were excluded.

Results: Eighty-one (96.4%) of 100 patients scheduled for TAVI were enrolled; seven (8.6%) developed AKI and 74 (91.4%) did not. The serum creatinine (SCr) level was significantly higher (p < 0.05) and the estimated glomerular filtration rate was significantly lower in the AKI group (p < 0.05). The CMV was significantly higher in the AKI group (103 ml vs 84 ml, p < 0.05), as was the CMV × SCr/BW value (3.34 vs 1.49, p < 0.01). The area under the curve for CMV × SCr/BW was 0.9228 and the cut-off value was 2.99. The CMV, SCr, and estimated glomerular filtration rate affect the likelihood of AKI after transfemoral TAVI and a CMV × SCr/BW value > 2.99 accurately predicts AKI.

Citing Articles

Factors Associated With Acute Kidney Injury in Patients Undergoing Transcatheter Aortic Valve Implantation: A Systematic Review and Meta-Analysis.

Benaicha K, Aldroubi B, Yousuf P, Nath R, Saveeta F, Kanwal F Cureus. 2023; 15(9):e45131.

PMID: 37842473 PMC: 10569799. DOI: 10.7759/cureus.45131.

Kidney injury as post-interventional complication of TAVI.

Morcos M, Burgdorf C, Vukadinivikj A, Mahfoud F, Latus J, Persson P Clin Res Cardiol. 2020; 110(3):313-322.

PMID: 32844282 DOI: 10.1007/s00392-020-01732-8.

References

Rihal C, Textor S, Grill D, Berger P, Ting H, Best P . Incidence and prognostic importance of acute renal failure after percutaneous coronary intervention. Circulation. 2002; 105(19):2259-64. DOI: 10.1161/01.cir.0000016043.87291.33. View

Freeman R, ODonnell M, Share D, Meengs W, Kline-Rogers E, Clark V . Nephropathy requiring dialysis after percutaneous coronary intervention and the critical role of an adjusted contrast dose. Am J Cardiol. 2002; 90(10):1068-73. DOI: 10.1016/s0002-9149(02)02771-6. View

Lok C, Austin P, Wang H, Tu J . Impact of renal insufficiency on short- and long-term outcomes after cardiac surgery. Am Heart J. 2004; 148(3):430-8. DOI: 10.1016/j.ahj.2003.12.042. View

Mehran R, Aymong E, Nikolsky E, Lasic Z, Iakovou I, Fahy M . A simple risk score for prediction of contrast-induced nephropathy after percutaneous coronary intervention: development and initial validation. J Am Coll Cardiol. 2004; 44(7):1393-9. DOI: 10.1016/j.jacc.2004.06.068. View

Loef B, Epema A, Smilde T, Henning R, Ebels T, Navis G . Immediate postoperative renal function deterioration in cardiac surgical patients predicts in-hospital mortality and long-term survival. J Am Soc Nephrol. 2004; 16(1):195-200. DOI: 10.1681/ASN.2003100875. View

Dangas G, Iakovou I, Nikolsky E, Aymong E, Mintz G, Kipshidze N . Contrast-induced nephropathy after percutaneous coronary interventions in relation to chronic kidney disease and hemodynamic variables. Am J Cardiol. 2004; 95(1):13-9. DOI: 10.1016/j.amjcard.2004.08.056. View

Mehta R, Kellum J, Shah S, Molitoris B, Ronco C, Warnock D . Acute Kidney Injury Network: report of an initiative to improve outcomes in acute kidney injury. Crit Care. 2007; 11(2):R31. PMC: 2206446. DOI: 10.1186/cc5713. View

Rosner M, Okusa M . Acute kidney injury associated with cardiac surgery. Clin J Am Soc Nephrol. 2007; 1(1):19-32. DOI: 10.2215/CJN.00240605. View

Marenzi G, Assanelli E, Campodonico J, Lauri G, Marana I, De Metrio M . Contrast volume during primary percutaneous coronary intervention and subsequent contrast-induced nephropathy and mortality. Ann Intern Med. 2009; 150(3):170-7. DOI: 10.7326/0003-4819-150-3-200902030-00006. View

10.

Aregger F, Wenaweser P, Hellige G, Kadner A, Carrel T, Windecker S . Risk of acute kidney injury in patients with severe aortic valve stenosis undergoing transcatheter valve replacement. Nephrol Dial Transplant. 2009; 24(7):2175-9. DOI: 10.1093/ndt/gfp036. View

11.

Bagur R, Webb J, Nietlispach F, Dumont E, De LaRochelliere R, Doyle D . Acute kidney injury following transcatheter aortic valve implantation: predictive factors, prognostic value, and comparison with surgical aortic valve replacement. Eur Heart J. 2009; 31(7):865-74. PMC: 2848323. DOI: 10.1093/eurheartj/ehp552. View

12.

Thomas M, Schymik G, Walther T, Himbert D, Lefevre T, Treede H . Thirty-day results of the SAPIEN aortic Bioprosthesis European Outcome (SOURCE) Registry: A European registry of transcatheter aortic valve implantation using the Edwards SAPIEN valve. Circulation. 2010; 122(1):62-9. DOI: 10.1161/CIRCULATIONAHA.109.907402. View

13.

Brown J, Robb J, Block C, Schoolwerth A, Kaplan A, OConnor G . Does safe dosing of iodinated contrast prevent contrast-induced acute kidney injury?. Circ Cardiovasc Interv. 2010; 3(4):346-50. PMC: 4843793. DOI: 10.1161/CIRCINTERVENTIONS.109.910638. View

14.

Nuis R, Van Mieghem N, Tzikas A, Piazza N, Otten A, Cheng J . Frequency, determinants, and prognostic effects of acute kidney injury and red blood cell transfusion in patients undergoing transcatheter aortic valve implantation. Catheter Cardiovasc Interv. 2010; 77(6):881-9. DOI: 10.1002/ccd.22874. View

15.

Sinning J, Ghanem A, Steinhauser H, Adenauer V, Hammerstingl C, Nickenig G . Renal function as predictor of mortality in patients after percutaneous transcatheter aortic valve implantation. JACC Cardiovasc Interv. 2010; 3(11):1141-9. DOI: 10.1016/j.jcin.2010.09.009. View

16.

Silva R, Silva N, Lucchesi F, Burdmann E . Prevention of contrast-induced nephropathy by use of bicarbonate solution: preliminary results and literature review. J Bras Nefrol. 2010; 32(3):292-302. View

17.

Van Linden A, Kempfert J, Rastan A, Holzhey D, Blumenstein J, Schuler G . Risk of acute kidney injury after minimally invasive transapical aortic valve implantation in 270 patients. Eur J Cardiothorac Surg. 2010; 39(6):835-42. DOI: 10.1016/j.ejcts.2010.11.034. View

18.

Elhmidi Y, Bleiziffer S, Piazza N, Hutter A, Opitz A, Hettich I . Incidence and predictors of acute kidney injury in patients undergoing transcatheter aortic valve implantation. Am Heart J. 2011; 161(4):735-9. DOI: 10.1016/j.ahj.2011.01.009. View

19.

Madershahian N, Scherner M, Liakopoulos O, Rahmanian P, Kuhn E, Hellmich M . Renal impairment and transapical aortic valve implantation: impact of contrast medium dose on kidney function and survival. Eur J Cardiothorac Surg. 2012; 41(6):1225-32. DOI: 10.1093/ejcts/ezr199. View

20.

Barbash I, Ben-Dor I, Dvir D, Maluenda G, Xue Z, Torguson R . Incidence and predictors of acute kidney injury after transcatheter aortic valve replacement. Am Heart J. 2012; 163(6):1031-6. DOI: 10.1016/j.ahj.2012.01.009. View