Atherosclerosis burden of the aortic valve and aorta and risk of acute kidney injury after transcatheter aortic valve implantation

Rosendael, Philippe J. van; Kamperidis, Vasileios; Kley, Frank van der; Katsanos, Spyridon; Amri, Ibtihal Al; Regeer, Madelien V.; Schalij, Martin J.; Weger, Arend de; Marsan, Nina Ajmone; Bax, Jeroen J.; Delgado, Victoria

doi:10.1016/j.jcct.2015.01.012

Cited by 34 publications

(12 citation statements)

References 28 publications

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“…It seems that the burden of noncalcified atherosclerosis was associated independently with AKI after adjusting for baseline renal function and AKI-related variables. 21 This evidence correlated with several studies demonstrating that patients with PVD exhibited independent risk factors of AKI after TAVR. 20,22 This hypothesized pathophysiology can be explained by a combination of factors including particulate atherosclerotic emboli generated during valvuloplasty, deployment of the valve, and catheter manipulation, as well as underlying renal disease.…”

supporting

confidence: 85%

The Renal Frontier in TAVR

Villablanca

Ramakrishna

2017

Journal of Cardiothoracic and Vascular Anesthesia

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supporting

confidence: 85%

The Renal Frontier in TAVR

Villablanca

Ramakrishna

2017

Journal of Cardiothoracic and Vascular Anesthesia

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“…Most included studies [ 13 – 22 , 24 – 28 , 34 ] used standard AKI definitions [modified Risk, Injury, and Failure; and Loss; and End-stage kidney disease (RIFLE) [ 35 ], Acute Kidney Injury Network (AKIN) [ 36 ] or Kidney Disease: Improving Global Outcomes (KDIGO) criteria [ 37 ]]. AKI was diagnosed 48–72 h following/after a TAVR procedure in most included studies and only six studies [ 13 , 15 , 18 , 24 , 27 , 28 ] identified AKI at 7 days following a TAVR procedure as suggested by Valve Academic Research Consortium-2 (VARC-2) consensus [ 38 ].…”

Section: Resultsmentioning

confidence: 99%

“…When meta-analysis was limited to the studies using standard AKI definitions, the pooled RR was 2.26 (95% CI 1.75–2.92; I 2 = 53%). We also performed a meta-analysis of studies using VARC-2 consensus [ 13 , 15 , 18 , 24 , 27 , 28 ]. The pooled RR of AKI in patients who underwent TA-TAVR was 2.19 (95% CI 1.37–3.49; I 2 = 44%).…”

Section: Resultsmentioning

confidence: 99%

The risk of acute kidney injury following transapical versus transfemoral transcatheter aortic valve replacement: a systematic review and meta-analysis

et al. 2016

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BackgroundThe aim of this systematic review is to examine the literature for the risk of acute kidney injury (AKI) in patients who underwent transcatheter aortic valve replacement (TAVR) based on transapical (TA) versus transfemoral (TF) approaches.MethodsA literature search was conducted utilizing Embase, Medline, Cochrane Database of Systematic Reviews and ClinicalTrials.gov from inception through December 2015. Studies that reported relative risk, odds ratio or hazard ratio comparing the AKI risk in patients who underwent TA-TAVR versus TF-TAVR were included. Pooled risk ratio (RR) and 95% confidence interval (CI) were calculated using a random effect, generic inverse variance method.ResultsSeventeen cohort studies with 5085 patients were enrolled in the analysis to assess the risk of AKI in patients undergoing TA-TAVR versus TF-TAVR. The pooled RR of AKI in patients who underwent TA-TAVR was 2.26 (95% CI 1.79–2.86) when compared with TF-TAVR. When meta-analysis was confined to the studies with adjusted analysis for confounders evaluating the risk of AKI following TAVR, the pooled RR of TA-TAVR was 2.89 (95% CI 2.12–3.94). The risk for moderate to severe AKI [RR 1.02 (95% CI 0.57–1.80)] in patients who underwent TA-TAVR compared with TF-TAVR was not significantly higher.ConclusionsOur meta-analysis demonstrates an association between TA-TAVR and a higher risk of AKI. Future studies are required to assess the risks of moderate to severe AKI and mortality following TA-TAVR versus TF-TAVR.

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“…It is estimated that about 30–85% of CCE patients have a history of invasive vascular procedure in the preceding 3 months, while only 4.3% had cholesterol embolism in age-matched controls that did not have invasive vascular procedure [6,7]. CCE is also a rare complication in patients undergoing the administration of anticoagulants (including heparin, low molecular weight heparin, warfarin, dabigatran) and thrombolytic therapy [2,7,8,9,10].…”

Section: Etiologymentioning

confidence: 99%

Cholesterol Crystal Embolism and Chronic Kidney Disease

Bayliss

Zhuang

2017

IJMS

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Renal disease caused by cholesterol crystal embolism (CCE) occurs when cholesterol crystals become lodged in small renal arteries after small pieces of atheromatous plaques break off from the aorta or renal arteries and shower the downstream vascular bed. CCE is a multisystemic disease but kidneys are particularly vulnerable to atheroembolic disease, which can cause an acute, subacute, or chronic decline in renal function. This life-threatening disease may be underdiagnosed and overlooked as a cause of chronic kidney disease (CKD) among patients with advanced atherosclerosis. CCE can result from vascular surgery, angiography, or administration of anticoagulants. Atheroembolic renal disease has various clinical features that resemble those found in other kidney disorders and systemic diseases. It is commonly misdiagnosed in clinic, but confirmed by characteristic renal biopsy findings. Therapeutic options are limited, and prognosis is considered to be poor. Expanding knowledge of atheroembolic renal disease due to CCE opens perspectives for recognition, diagnosis, and treatment of this cause of progressive renal insufficiency.

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Atherosclerosis burden of the aortic valve and aorta and risk of acute kidney injury after transcatheter aortic valve implantation

Cited by 34 publications

References 28 publications

The Renal Frontier in TAVR

The Renal Frontier in TAVR

The risk of acute kidney injury following transapical versus transfemoral transcatheter aortic valve replacement: a systematic review and meta-analysis

Cholesterol Crystal Embolism and Chronic Kidney Disease

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