title: Acute kidney injury after transcatheter aortic valve implantation: Impact of contrast agents, predictive factors, and prognostic importance in 203 patients with long-term follow-up.
abstract: BACKGROUND
  Acute kidney injury (AKI) frequently occurs following transcatheter aortic valve implantation (TAVI) and has been related to a worse outcome. We investigated the importance of contrast medium composition, either iso-osmolar (IOCM) or low-osmolar (LOCM) and assessed predictors for AKI after TAVI.
  
  
  RESULTS
  We assessed AKI in 203 TAVI patients treated mainly with trans-femoral implantation and analgosedation. A total of 100 patients received IOCM and 103 LOCM. AKI was defined according to the Valve Academic Research Consortium. Following TAVI, 39 patients (19.2%) developed AKI; 17.0% of the IOCM and 21.4% of the LOCM group (p=0.43). The only independent predictor for AKI was baseline serum creatinine [odds ratio (OR) 0.26, 95% confidence interval (CI) 0.01-0.64, p=0.002]. Patients with advanced AKI (stages 2 and 3) post-TAVI had significantly higher mortality at 2 years (log rank p<0.001), whereas patients with AKI stage 1 had a similar long-term outcome to non-AKI patients.
  
  
  CONCLUSIONS
  Following TAVI, we observed no difference in the occurrence of AKI between IOCM and LOCM. Baseline creatinine was the only independent predictor of AKI, and patients who developed advanced AKI had significantly higher mortality at 2 years.
authors: Cardiology Department, Heart Center, Segeberger Kliniken GmbH (Academic Teaching Hospital of the Universities of Kiel and Hamburg), Bad Segeberg, Germany. Electronic address: chatani.kenichi@gmail.com.
authors: Kenichi
authors: K
authors: Chatani
authors: Cardiology Department, Heart Center, Segeberger Kliniken GmbH (Academic Teaching Hospital of the Universities of Kiel and Hamburg), Bad Segeberg, Germany.
authors: Mohamed
authors: M
authors: Abdel-Wahab
authors: Cardiology Department, Heart Center, Segeberger Kliniken GmbH (Academic Teaching Hospital of the Universities of Kiel and Hamburg), Bad Segeberg, Germany.
authors: Nora
authors: N
authors: Wübken-Kleinfeld
authors: Cardiology Department, Heart Center, Segeberger Kliniken GmbH (Academic Teaching Hospital of the Universities of Kiel and Hamburg), Bad Segeberg, Germany.
authors: Ken
authors: K
authors: Gordian
authors: Cardiology Department, Heart Center, Segeberger Kliniken GmbH (Academic Teaching Hospital of the Universities of Kiel and Hamburg), Bad Segeberg, Germany.
authors: Kathrin
authors: K
authors: Pötzing
authors: Cardiology Department, Heart Center, Segeberger Kliniken GmbH (Academic Teaching Hospital of the Universities of Kiel and Hamburg), Bad Segeberg, Germany.
authors: Ahmad E
authors: AE
authors: Mostafa
authors: Cardiovascular Surgery Department, Heart Center, Segeberger Kliniken GmbH, Bad Segeberg, Germany.
authors: Ernst-Günter
authors: EG
authors: Kraatz
authors: Cardiovascular Surgery Department, University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck, Germany.
authors: Doreen
authors: D
authors: Richardt
authors: Cardiology Department, Heart Center, Segeberger Kliniken GmbH (Academic Teaching Hospital of the Universities of Kiel and Hamburg), Bad Segeberg, Germany.
authors: Mohamed
authors: M
authors: El-Mawardy
authors: Cardiology Department, Heart Center, Segeberger Kliniken GmbH (Academic Teaching Hospital of the Universities of Kiel and Hamburg), Bad Segeberg, Germany.
authors: Gert
authors: G
authors: Richardt
mesh_terms: D058186:Acute Kidney Injury / Q000097:blood / Q000209:etiology* / Q000401:mortality; D000368:Aged; D000369:Aged, 80 and over; D001024:Aortic Valve Stenosis / Q000097:blood / Q000601:surgery*; D006328:Cardiac Catheterization / Q000009:adverse effects*; D003287:Contrast Media / Q000009:adverse effects* / Q000737:chemistry; D003404:Creatinine / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D016017:Odds Ratio; D009994:Osmolar Concentration; D011379:Prognosis; D012307:Risk Factors; D013997:Time Factors; D065467:Transcatheter Aortic Valve Replacement / Q000009:adverse effects*
chemical_list: D003287:Contrast Media; D003404:Creatinine
keywords: Acute kidney injury; Contrast medium; Long-term clinical outcome; Transcatheter aortic valve implantation