Incidence, predictors, and effects of acute kidney injury after percutaneous valve implantation.
BACKGROUND
Acute kidney injury is a common complication after surgical aortic replacement and entails a worse prognosis. Percutaneous valve implantation is an alternative to surgical replacement. We sought to elucidate incidence, predictors, and effects of acute kidney injury after percutaneous aortic valve implantation.


METHODS
A cohort of consecutive patients who underwent percutaneous aortic valve implantation at one center were studied, excluding those who died in the first 24 hours and those on prior hemodialysis.


RESULTS
A total of 131 patients (age, 80.8 ± 6 years; 42% male; Euroscore II, 10.27 ± 6.9) were included. Acute kidney injury was defined as a reduction >25% in glomerular filtration rate (GFR). GFR was 62.09 ± 22 mL/min/1.73 m² at baseline, 62.7 ± 25 mL/min/1.73 m² after the procedure, and 68.03 ± 25 mL/min/1.73 m² at discharge. Acute kidney injury appeared in 17 patients (13%). Of these, 11 recovered and only 6 (4.5%) showed impaired GFR >25% upon discharge. Patients with acute kidney injury showed longer hospitalization length (median 7 days [IQR, 5-12 days] vs 3 days [IQR, 2-6 days]; P=.01) and higher 30-day mortality rate (17.6% vs 0.9%; P=.01). The only independent predictor for acute kidney injury development was Euroscore II (odds ratio, 1.192; confidence interval, 1.042-1.326; P=.01).


CONCLUSIONS
Incidence of acute kidney injury after transcatheter aortic valve implantation was 13% in our cohort. Patients with acute kidney injury showed longer hospitalization and higher 30-day mortality rate. Euroscore II was an independent predictor of acute kidney injury.
Unidad de Hemodinamica- Servicio de Cardiologia, Hospital Universitario Virgen de la Arrixaca, Carretera Cartagena SN 30110 Murcia, Spain. jgarciadelara@gmail.com.
J
J
García-Lara
E
E
Pinar-Bermúdez
J R
JR
Gimeno-Blanes
J
J
Lacunza-Ruiz
J A
JA
Hurtado Martinez
R
R
Valdesuso-Aguilar
M
M
Valdés-Chávarri
D058186:Acute Kidney Injury / Q000453:epidemiology* / Q000401:mortality / Q000503:physiopathology; D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve; D001024:Aortic Valve Stenosis / Q000628:therapy*; D006328:Cardiac Catheterization; D015331:Cohort Studies; D005260:Female; D005919:Glomerular Filtration Rate / Q000502:physiology; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D015994:Incidence; D007902:Length of Stay; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology* / Q000401:mortality / Q000503:physiopathology; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate