title: Independent Risk Factors Contributing to Acute Kidney Injury According to Updated Valve Academic Research Consortium-2 Criteria After Transcatheter Aortic Valve Implantation: A Meta-analysis and Meta-regression of 13 Studies.
abstract: OBJECTIVE
  This study aimed to examine the risk factors for transcatheter aortic valve implantation (TAVI)-associated acute kidney injury (AKI) according to the AKI definition from the Valve Academic Research Consortium-2 (VARC-2).
  
  
  METHODS
  A meta-analysis.
  
  
  METHODS
  A total of 661 patients with post-TAVI AKI according to the VARC-2 definition and 2,012 controls were included in the meta-analysis.
  
  
  METHODS
  Patients undergoing TAVI were included in this meta-analysis.
  
  
  RESULTS
  Multiple electronic databases were searched using predefined criteria. The diagnosis of AKI was based on the VARC-2 classification. The authors found that preoperative New York Heart Association class IV (odds ratio [OR], 7.77; 95% confidence interval [CI], 3.81-15.85), previous chronic renal disease (CKD) (OR, 2.81; 95% CI, 1.96-4.03), and requirement for transfusion (OR, 2.03; 95% CI, 1.59-2.59) were associated significantly with an increased risk for post-TAVI AKI. Furthermore, previous peripheral vascular disease (PVD), hypertension, atrial fibrillation, congestive heart failure, diabetes mellitus, and stroke were also risk factors for TAVI-associated AKI. Additionally, transfemoral access significantly correlated with a reduced risk for post-TAVI AKI (OR, 0.43; 95% CI, 0.33-0.57). The potential confounders, including Society of Thoracic Surgeons Score, the logistic European System for Cardiac Operative Risk Evaluation, aortic valve area, mean pressure gradient, left ventricular ejection fraction, age, body mass index, contrast volume, and valve type, had no impact on the association between the risk factors and post-TAVI AKI. Subgroup analysis of the eligible studies presenting multivariate logistic regression analysis on the independent risk factors for post-TAVI AKI revealed that previous CKD, previous PVD, and transapical access were independent risk factors for TAVI-associated AKI.
  
  
  CONCLUSIONS
  The current meta-analysis suggested that previous CKD, previous PVD, and transapical access may be independent risk factors for TAVI-associated AKI.
authors.affiliation: Department of Cardiac Surgery, Beijing An Zhen Hospital Capital Medical University, Beijing, China; Center for Cardiac Intensive Care, Beijing An Zhen Hospital Capital Medical University, Beijing, China.
authors.forename: Jiayang
authors.initials: J
authors.lastname: Wang
authors.affiliation: Department of Cardiac Surgery, Beijing An Zhen Hospital Capital Medical University, Beijing, China.
authors.forename: Wenyuan
authors.initials: W
authors.lastname: Yu
authors.affiliation: Center for Cardiac Intensive Care, Beijing An Zhen Hospital Capital Medical University, Beijing, China.
authors.forename: Ye
authors.initials: Y
authors.lastname: Zhou
authors.affiliation: Center for Cardiac Intensive Care, Beijing An Zhen Hospital Capital Medical University, Beijing, China.
authors.forename: Yong
authors.initials: Y
authors.lastname: Yang
authors.affiliation: Center for Cardiac Intensive Care, Beijing An Zhen Hospital Capital Medical University, Beijing, China.
authors.forename: Chenglong
authors.initials: C
authors.lastname: Li
authors.affiliation: Center for Cardiac Intensive Care, Beijing An Zhen Hospital Capital Medical University, Beijing, China. Electronic address: ln9102@vip.sina.com.
authors.forename: Nan
authors.initials: N
authors.lastname: Liu
authors.affiliation: Center for Cardiac Intensive Care, Beijing An Zhen Hospital Capital Medical University, Beijing, China.
authors.forename: Xiaotong
authors.initials: X
authors.lastname: Hou
authors.affiliation: Department of Cardiac Surgery, Beijing An Zhen Hospital Capital Medical University, Beijing, China.
authors.forename: Longfei
authors.initials: L
authors.lastname: Wang
mesh_terms: D000046:Academic Medical Centers / Q000639:trends; D058186:Acute Kidney Injury / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D064887:Observational Studies as Topic / Q000379:methods; D012044:Regression Analysis; D012307:Risk Factors; D065467:Transcatheter Aortic Valve Replacement / Q000009:adverse effects* / Q000639:trends
keywords: Valve Academic Research Consortium-2; acute kidney injury; independent risk factor; transcatheter aortic valve implantation