Incidence of Acute Kidney Injury in Patients with Chronic Renal Insufficiency: Transcatheter versus Surgical Aortic Valve Replacement

Objectives. The objective of this study is to determine incidence of acute kidney injury (AKI) associated with transcatheter aortic valve replacement (TAVR) versus surgical aortic valve replacement (SAVR) in patients with preexisting chronic kidney disease. Background. The incidence of AKI in patien...

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Main Authors: Michael Catalano, Dishen Lin, Hugh Cassiere, Nina Kohn, Bruce Rutkin, Greg Maurer, Jacinda A. Berg, Jaclyn Jahn, Rick Esposito, Alan Hartman, Pey-Jen Yu
Format: Article
Language:English
Published: Wiley 2019-01-01
Series:Journal of Interventional Cardiology
Online Access:http://dx.doi.org/10.1155/2019/9780415
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author Michael Catalano
Dishen Lin
Hugh Cassiere
Nina Kohn
Bruce Rutkin
Greg Maurer
Jacinda A. Berg
Jaclyn Jahn
Rick Esposito
Alan Hartman
Pey-Jen Yu
author_facet Michael Catalano
Dishen Lin
Hugh Cassiere
Nina Kohn
Bruce Rutkin
Greg Maurer
Jacinda A. Berg
Jaclyn Jahn
Rick Esposito
Alan Hartman
Pey-Jen Yu
author_sort Michael Catalano
collection DOAJ
description Objectives. The objective of this study is to determine incidence of acute kidney injury (AKI) associated with transcatheter aortic valve replacement (TAVR) versus surgical aortic valve replacement (SAVR) in patients with preexisting chronic kidney disease. Background. The incidence of AKI in patients with preexisting renal insufficiency undergoing TAVR versus SAVR is not well described. Methods. All patients with preexisting chronic kidney disease who underwent SAVR for aortic stenosis with or without concomitant coronary artery bypass grafting or TAVR from 5/2008 to 6/2017. Patients requiring preoperative hemodialysis were excluded. Chronic kidney disease was defined as an estimated glomerular filtrate rate (eGFR) of < 60 mL/min/1.73 m2. The incidence of postoperative AKI was compared using the RIFLE classification system for acute kidney injury. Results. A total of 406 SAVR patients and 407 TAVR patients were included in this study. TAVR patients were older and had lower preoperative eGFR as compared to SAVR patients. Covariate adjustment using propensity score between the two groups showed that SAVR patients were more likely to have a more severe degree of postoperative AKI as compared to TAVR patients (OR = 4.75; 95% CI: 3.15, 7.17; p <.001). SAVR patients were more likely to require dialysis postoperatively as compared to TAVR patients (OR = 4.55; 95% CI: 1.29, 15.99; p <.018). Conclusion. In patients with preexisting chronic kidney disease, TAVR was associated with significantly less AKI as compared to SAVR.
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spelling doaj-art-d085ffeecf25422aa05ea22c23202d162025-08-20T02:20:05ZengWileyJournal of Interventional Cardiology0896-43271540-81832019-01-01201910.1155/2019/97804159780415Incidence of Acute Kidney Injury in Patients with Chronic Renal Insufficiency: Transcatheter versus Surgical Aortic Valve ReplacementMichael Catalano0Dishen Lin1Hugh Cassiere2Nina Kohn3Bruce Rutkin4Greg Maurer5Jacinda A. Berg6Jaclyn Jahn7Rick Esposito8Alan Hartman9Pey-Jen Yu10Division of Cardiovascular and Thoracic Surgery, Zucker School of Medicine at Hofstra/Northwell, 300 Community Drive, 1DSU, Manhasset, NY 11030, USADivision of Cardiovascular and Thoracic Surgery, Zucker School of Medicine at Hofstra/Northwell, 300 Community Drive, 1DSU, Manhasset, NY 11030, USADivision of Cardiovascular and Thoracic Surgery, Zucker School of Medicine at Hofstra/Northwell, 300 Community Drive, 1DSU, Manhasset, NY 11030, USAThe Feinstein Institute for Medical Research, 350 Community Drive, Manhasset, NY 11030, USADivision of Cardiovascular and Thoracic Surgery, Zucker School of Medicine at Hofstra/Northwell, 300 Community Drive, 1DSU, Manhasset, NY 11030, USADivision of Cardiovascular and Thoracic Surgery, Zucker School of Medicine at Hofstra/Northwell, 300 Community Drive, 1DSU, Manhasset, NY 11030, USADivision of Cardiovascular and Thoracic Surgery, Zucker School of Medicine at Hofstra/Northwell, 300 Community Drive, 1DSU, Manhasset, NY 11030, USADivision of Cardiovascular and Thoracic Surgery, Zucker School of Medicine at Hofstra/Northwell, 300 Community Drive, 1DSU, Manhasset, NY 11030, USADivision of Cardiovascular and Thoracic Surgery, Zucker School of Medicine at Hofstra/Northwell, 300 Community Drive, 1DSU, Manhasset, NY 11030, USADivision of Cardiovascular and Thoracic Surgery, Zucker School of Medicine at Hofstra/Northwell, 300 Community Drive, 1DSU, Manhasset, NY 11030, USADivision of Cardiovascular and Thoracic Surgery, Zucker School of Medicine at Hofstra/Northwell, 300 Community Drive, 1DSU, Manhasset, NY 11030, USAObjectives. The objective of this study is to determine incidence of acute kidney injury (AKI) associated with transcatheter aortic valve replacement (TAVR) versus surgical aortic valve replacement (SAVR) in patients with preexisting chronic kidney disease. Background. The incidence of AKI in patients with preexisting renal insufficiency undergoing TAVR versus SAVR is not well described. Methods. All patients with preexisting chronic kidney disease who underwent SAVR for aortic stenosis with or without concomitant coronary artery bypass grafting or TAVR from 5/2008 to 6/2017. Patients requiring preoperative hemodialysis were excluded. Chronic kidney disease was defined as an estimated glomerular filtrate rate (eGFR) of < 60 mL/min/1.73 m2. The incidence of postoperative AKI was compared using the RIFLE classification system for acute kidney injury. Results. A total of 406 SAVR patients and 407 TAVR patients were included in this study. TAVR patients were older and had lower preoperative eGFR as compared to SAVR patients. Covariate adjustment using propensity score between the two groups showed that SAVR patients were more likely to have a more severe degree of postoperative AKI as compared to TAVR patients (OR = 4.75; 95% CI: 3.15, 7.17; p <.001). SAVR patients were more likely to require dialysis postoperatively as compared to TAVR patients (OR = 4.55; 95% CI: 1.29, 15.99; p <.018). Conclusion. In patients with preexisting chronic kidney disease, TAVR was associated with significantly less AKI as compared to SAVR.http://dx.doi.org/10.1155/2019/9780415
spellingShingle Michael Catalano
Dishen Lin
Hugh Cassiere
Nina Kohn
Bruce Rutkin
Greg Maurer
Jacinda A. Berg
Jaclyn Jahn
Rick Esposito
Alan Hartman
Pey-Jen Yu
Incidence of Acute Kidney Injury in Patients with Chronic Renal Insufficiency: Transcatheter versus Surgical Aortic Valve Replacement
Journal of Interventional Cardiology
title Incidence of Acute Kidney Injury in Patients with Chronic Renal Insufficiency: Transcatheter versus Surgical Aortic Valve Replacement
title_full Incidence of Acute Kidney Injury in Patients with Chronic Renal Insufficiency: Transcatheter versus Surgical Aortic Valve Replacement
title_fullStr Incidence of Acute Kidney Injury in Patients with Chronic Renal Insufficiency: Transcatheter versus Surgical Aortic Valve Replacement
title_full_unstemmed Incidence of Acute Kidney Injury in Patients with Chronic Renal Insufficiency: Transcatheter versus Surgical Aortic Valve Replacement
title_short Incidence of Acute Kidney Injury in Patients with Chronic Renal Insufficiency: Transcatheter versus Surgical Aortic Valve Replacement
title_sort incidence of acute kidney injury in patients with chronic renal insufficiency transcatheter versus surgical aortic valve replacement
url http://dx.doi.org/10.1155/2019/9780415
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