title: Impact of interaction of diabetes mellitus and impaired renal function on prognosis and the incidence of acute kidney injury in patients undergoing transcatheter aortic valve replacement (TAVR).
abstract: BACKGROUND
  In high-risk patients with severe aortic stenosis undergoing transcatheter aortic valve replacement (TAVR) diabetes mellitus (DM) is a common comorbidity. It is known to increase the risk of arteriosclerosis and adversely affect morbidity, mortality for all types of cardiovascular disease, and post-procedural outcome after percutaneous and surgical procedures. Moreover, DM is known to facilitate the genesis of renal failure (RF). Pre-existing RF seems to increase the rate of acute kidney injury (AKI), which is a powerful short- and midterm predictor of mortality in patients undergoing TAVR. Therefore, the aim of the present study was to investigate the impact of DM on AKI, short- and midterm prognosis after TAVR, especially in patients with pre-existing RF.
  
  
  RESULTS
  In 337(30%) of 1109 patients DM was documented. The incidence of RF at baseline (GFR <60mL/min) was statistically similar in both patient groups (no DM vs. DM: 54% vs. 61%; p=0.057). Also, the incidence of AKI stage 3 was similar in all patients (no DM vs. DM: 1.6% vs. 1.8%; p=0.799). There were no significant differences regarding the procedure-related complications according to VARC-2 and mortality between patients neither with nor without DM. Even after differentiating patients according to baseline renal function, similar incidence of AKI and midterm mortality were documented.
  
  
  CONCLUSIONS
  In patients undergoing TAVR, neither in case of preserved nor impaired renal function, we couldn't find any evidence for influence of DM on overall acute and midterm prognosis nor the incidence of AKI.
authors.affiliation: Department of General and Interventional Cardiology, Asklepios Clinic St. Georg Hospital, Hamburg, Germany. Electronic address: d.schewel@gmx.de.
authors.forename: Dimitry
authors.initials: D
authors.lastname: Schewel
authors.affiliation: Department of General and Interventional Cardiology, Asklepios Clinic St. Georg Hospital, Hamburg, Germany.
authors.forename: Milad
authors.initials: M
authors.lastname: Zavareh
authors.affiliation: Department of General and Interventional Cardiology, Asklepios Clinic St. Georg Hospital, Hamburg, Germany.
authors.forename: Jury
authors.initials: J
authors.lastname: Schewel
authors.affiliation: Department of General and Interventional Cardiology, Asklepios Clinic St. Georg Hospital, Hamburg, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Thielsen
authors.affiliation: Department of General and Interventional Cardiology, Asklepios Clinic St. Georg Hospital, Hamburg, Germany.
authors.forename: Tobias
authors.initials: T
authors.lastname: Schmidt
authors.affiliation: Department of General and Interventional Cardiology, Asklepios Clinic St. Georg Hospital, Hamburg, Germany.
authors.forename: Ulrich
authors.initials: U
authors.lastname: Schäfer
authors.affiliation: Department of General and Interventional Cardiology, Asklepios Clinic St. Georg Hospital, Hamburg, Germany.
authors.forename: Karl-Heinz
authors.initials: KH
authors.lastname: Kuck
authors.affiliation: Department of General and Interventional Cardiology, Asklepios Clinic St. Georg Hospital, Hamburg, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Frerker
mesh_terms: D058186:Acute Kidney Injury / Q000453:epidemiology* / Q000209:etiology; D000368:Aged; D000369:Aged, 80 and over; D001024:Aortic Valve Stenosis / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000453:epidemiology*; D017548:Echocardiography, Transesophageal; D005260:Female; D005500:Follow-Up Studies; D005858:Germany / Q000453:epidemiology; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D015994:Incidence; D008297:Male; D011183:Postoperative Complications; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D012720:Severity of Illness Index; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D065467:Transcatheter Aortic Valve Replacement / Q000009:adverse effects*