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Effect of Transcatheter Aortic Valve Implantation on Renal Function in Patients With Previous Renal Dysfunction
- Source :
- The American Journal of Cardiology. 124:85-89
- Publication Year :
- 2019
- Publisher :
- Elsevier BV, 2019.
-
Abstract
- The study aims to investigate the incidence of immediate renal function improvement in renal dysfunction patients who had transcatheter aortic valve implantation (TAVI). TAVI patients with ≥ moderate reduced renal function [estimated GFR ≤ 60 ml/min/1.73 m2] at baseline were identified from a prospectively maintained database. Patients were divided into 3 groups based on percent change [(discharge eGFR − baseline eGFR/baseline GFR) × 100] in eGFR post-TAVR. Improvement ≥ 10%, no change, Decline ≥ 10%. Multivariable logistic regression was performed to identify factors that predicted improvement/decline in GFR postprocedure. Out of 677 patients, 359 (53%) had eGFR ≤ 60 ml/min/1.73 m2. Of these, 188 (52%) had an improvement in eGFR ≥ 10%, 125 (34%) had no change and 48 (14%) observed decline ≥ 10%. All groups had similar proportions of females and age was comparable in patient groups. Patients in whom a decline in eGFR was observed had significantly higher Society of thoracic Surgeons scores (10.7 vs 8.2 vs 8.2; p = 0.007) and incidence of liver disease (6% vs, 0% vs 2%; p = 0.014) than the no-change or improved groups respectively. On multivariable analysis, independent predictors of decline/improvement in eGFR were being female, low left ventricular ejection fraction and baseline liver dysfunction. In conclusion, over half of patients with compromised renal function who underwent TAVI experience an immediate improvement in kidney function post-TAVI. Being female, baseline liver dysfunction and a low left ventricular ejection fraction is associated with an immediate decline in eGFR.
- Subjects :
- Male
medicine.medical_specialty
Transcatheter aortic
Renal function
030204 cardiovascular system & hematology
Logistic regression
Cohort Studies
Transcatheter Aortic Valve Replacement
03 medical and health sciences
Liver disease
0302 clinical medicine
Risk Factors
Internal medicine
medicine
Humans
Renal Insufficiency
030212 general & internal medicine
Aged
Aged, 80 and over
Ejection fraction
business.industry
Incidence
Incidence (epidemiology)
Stroke Volume
Aortic Valve Stenosis
Stroke volume
medicine.disease
Logistic Models
Treatment Outcome
Cardiology
Female
Cardiology and Cardiovascular Medicine
business
Glomerular Filtration Rate
Cohort study
Subjects
Details
- ISSN :
- 00029149
- Volume :
- 124
- Database :
- OpenAIRE
- Journal :
- The American Journal of Cardiology
- Accession number :
- edsair.doi.dedup.....0ba9b4b0a33a0a53d85cd06c0df46495