title: Prognostic value of renal function in patients with aortic stenosis treated with transcatheter aortic valve replacement.
abstract: OBJECTIVE
  The objectives of the present study were to analyze the variation of renal function after transcatheter aortic valve replacement (TAVR) focused on acute kidney injury (AKI) and its impact on short- and mid-term mortality.
  
  
  BACKGROUND
  Changes on renal function after TAVR and their impact on clinical outcomes are incompletely understood until now.
  
  
  METHODS
  At two tertiary centers 221 consecutive patients were submitted to TAVR. Kidney injury was defined according to VARC-2 criteria. Patients were classified according to the presence (group 1) or absence (group 2) of AKI. Creatinine values were collected daily until seventh day after procedure, 1 month, 6 months, and then 1 year after TAVR.
  
  
  RESULTS
  At baseline, groups were similar, except for EuroSCORE II (8.66% vs. 7.34%, P = 0.02) and glomerular filtration rate (GFR) (39.59 vs. 48.49 mL/min.1.73 m2, P = 0.002). Overall 30 day-mortality and 1-year mortality were 6.3% and 14.0%, respectively. Both 30-day mortality (23.1% vs. 1.2%, P < 0.001) and 1-year mortality (44.2% vs. 4.7%, P < 0.001) were higher in group 1. After multivariable-adjusted models, the only independent predictor for AKI after TAVR was baseline GFR (HR: 1.37, 95% CI: 1.08-1.77, P = 0.01). The independent risk factors for 1-year mortality were AKI (HR: 15.66, 95% CI: 6.07-44.63, P < 0.001), COPD (HR: 3.14, 95% CI: 1.05-9.40, P = 0.04) and aortic regurgitation grade postprocedure ≥ 2 (P = 0.05) also after multivariate analysis.
  
  
  CONCLUSIONS
  In this TAVR cohort, baseline GFR was the only independent predictor of AKI, which negatively impacted on 30-day and 1-year mortality. © 2016 Wiley Periodicals, Inc.
authors: Instituto Dante Pazzanese de Cardiologia, São Paulo, Brazil.
authors: Rafael A
authors: RA
authors: Meneguz-Moreno
authors: Instituto Dante Pazzanese de Cardiologia, São Paulo, Brazil.
authors: Auristela Io
authors: AI
authors: Ramos
authors: Instituto Dante Pazzanese de Cardiologia, São Paulo, Brazil.|Hospital do Coração, São Paulo, Brazil.
authors: Dimytri
authors: D
authors: Siqueira
authors: Instituto Dante Pazzanese de Cardiologia, São Paulo, Brazil.
authors: Antonio
authors: A
authors: de Castro-Filho
authors: Instituto Dante Pazzanese de Cardiologia, São Paulo, Brazil.
authors: Tannas
authors: http://orcid.org/0000-0003-2245-2131
authors: T
authors: Jatene
authors: Instituto Dante Pazzanese de Cardiologia, São Paulo, Brazil.
authors: Andreia
authors: A
authors: Dias Jeronimo
authors: Instituto Dante Pazzanese de Cardiologia, São Paulo, Brazil.
authors: David
authors: D
authors: Le Bihan
authors: Hospital do Coração, São Paulo, Brazil.
authors: Adriana
authors: A
authors: Moreira
authors: Instituto Dante Pazzanese de Cardiologia, São Paulo, Brazil.|Hospital do Coração, São Paulo, Brazil.
authors: Magaly
authors: M
authors: Arrais
authors: Instituto Dante Pazzanese de Cardiologia, São Paulo, Brazil.|Hospital do Coração, São Paulo, Brazil.
authors: Alexandre
authors: A
authors: Abizaid
authors: Instituto Dante Pazzanese de Cardiologia, São Paulo, Brazil.|Hospital do Coração, São Paulo, Brazil.
authors: Amanda
authors: A
authors: Sousa
authors: Instituto Dante Pazzanese de Cardiologia, São Paulo, Brazil.|Hospital do Coração, São Paulo, Brazil.
authors: J
authors: J
authors: Eduardo Sousa
mesh_terms: D058186:Acute Kidney Injury / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality / Q000503:physiopathology; D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000000981:diagnostic imaging / Q000503:physiopathology; D001024:Aortic Valve Stenosis / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D015415:Biomarkers / Q000097:blood; D001938:Brazil; D006328:Cardiac Catheterization / Q000009:adverse effects* / Q000295:instrumentation / Q000379:methods; D016009:Chi-Square Distribution; D003404:Creatinine / Q000097:blood; D004452:Echocardiography; D005260:Female; D005919:Glomerular Filtration Rate; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects* / Q000295:instrumentation / Q000379:methods; D006801:Humans; D053208:Kaplan-Meier Estimate; D007668:Kidney / Q000503:physiopathology*; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D016017:Odds Ratio; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D062606:Tertiary Care Centers; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D003404:Creatinine
keywords: acute renal disease; aortic valve disease; transcatheter valve implantation