Doppler-based renal resistance index for the detection of acute kidney injury and the non-invasive evaluation of paravalvular aortic regurgitation after transcatheter aortic valve implantation

Sinning, Jan‐Malte; Adenauer, Viktoria; Scheer, Anne-Cathérine; Cachiguango, Sisa Josefina Lema; Ghanem, Alexander; Hammerstingl, Christoph; Sedaghat, Alexander; Müller, Cornelius; Vasa‐Nicotera, Mariuca; Grube, Eberhard; Nickenig, Georg; Werner, Nikos

doi:10.4244/eijv9i11a221

Cited by 21 publications

(11 citation statements)

References 35 publications

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“…Of 273 articles identified by the initial search, 66 were retrieved for more detailed evaluation, and 24 trials were included in the study (Fig. ) . The characteristics of the included studies are reported in Table .…”

Section: Resultsmentioning

confidence: 99%

“…AKI has emerged as an independent predictor of mortality after SAVR , but data concerning its impact on mortality after TAVI were not unique and conclusive with some studies indicating an increased mortality , while others showing no significant effects . In the study by Saia et al, the presence of AKI did not have an impact on 1‐year mortality, while only AKI 3 emerged as a significant predictor of it .…”

Section: Discussionmentioning

confidence: 98%

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Impact of postoperative acute kidney injury on clinical outcomes after transcatheter aortic valve implantation: A meta‐analysis of 5,971 patients

Gargiulo

Sannino

Capodanno

et al. 2015

Cathet Cardio Intervent

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 98%

Impact of postoperative acute kidney injury on clinical outcomes after transcatheter aortic valve implantation: A meta‐analysis of 5,971 patients

Gargiulo

Sannino

Capodanno

et al. 2015

Cathet Cardio Intervent

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“…Meanwhile, Doppler-based RRI measurements can be useful in early AKI detection. Sinning et al proved that RRI was able to indicate AKI in the clinically crucial early hours immediately following the TAVR procedure, which was earlier than the rise in either creatinine or cystatin C 35. Although encouraging, both devices await their broad acceptance in everyday practice.…”

Section: Preventionmentioning

confidence: 99%

<p>Acute kidney injury after transcatheter aortic valve replacement in the elderly: outcomes and risk management</p>

Załęska‐Kocięcka¹,

Dąbrowski²,

Stępińska³

2019

CIA

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Aortic stenosis is the most common cause of valve replacement in Europe and North America with prevalence increasing with age. Transcatheter valve replacement (TAVR) represents an alternative for surgical valve replacement of severely stenotic valves. Despite lower risk of acute kidney injury compared to that associated with surgery, this complication remains prevalent in patients undergoing TAVR. There is a paucity of data confirming the relation of acute kidney injury with high morbidity and mortality, especially when superimposed on chronic kidney disease, which is a frequent comorbidity in the elderly with severe aortic stenosis. As there is no consensus on the prevention of acute kidney injury in patients undergoing TAVR, identification and limitation of risk factors are crucial. In this review, we aim to discuss the key aspects of acute kidney injury diagnosis, risk assessment, and outcomes in TAVR patients, and to point out gaps in current knowledge.

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“…While the attempts to reduce stroke rates by TAVR embolic protection systems are promising ( 62 ), future studies on intervention or preventive measures to prevent renal emboli, especially in patients with CKD, are needed. Another intervention which requires further validation is the use of a Doppler-based renal resistance index to predict and identify patients at risk for AKI ( 63 ). In the future, progress in the research of urine biomarkers ( 64 ), electronic health records with an AKI alert ( 65 ) for early AKI detection, and risk stratification models will likely improve the renal outcomes of patients undergoing TAVR.…”

Section: Measures To Prevent Aki After Tavrmentioning

confidence: 99%

Transcatheter aortic valve replacement; a kidney’s perspective

Cheungpasitporn¹,

Kashani²

2016

J Renal Inj Prev

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Transcatheter aortic valve replacement (TAVR) has now emerged as a viable treatment option for high-risk patients with severe aortic stenosis (AS) who are not suitable candidates for surgical aortic valve replacement (SAVR). Despite encouraging published outcomes, acute kidney injury (AKI) is common and lowers the survival of patients after TAVR. The pathogenesis of AKI after TAVR is multifactorial including TAVR specific factors such as the use of contrast agents, hypotension during rapid pacing, and embolization; preventive measures may include pre-procedural hydration, limitation of contrast dye exposure, and avoidance of intraprocedural hypotension. In recent years, the number of TAVR performed worldwide has been increasing, as well as published data on renal perspectives of TAVR including AKI, chronic kidney disease, end-stage kidney disease, and kidney transplantation. This review aims to present the current literature on the nephrology aspects of TAVR, ultimately to improve the patients’ quality of care and outcomes.

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Doppler-based renal resistance index for the detection of acute kidney injury and the non-invasive evaluation of paravalvular aortic regurgitation after transcatheter aortic valve implantation

Abstract: Measurement of the Doppler-based RRI predicts risk for AKI and increased mortality rates at an early post-procedural time point and is related to the occurrence of more-than-mild paravalvular aortic regurgitation after TAVI.

Cited by 21 publications

References 35 publications

Impact of postoperative acute kidney injury on clinical outcomes after transcatheter aortic valve implantation: A meta‐analysis of 5,971 patients

Impact of postoperative acute kidney injury on clinical outcomes after transcatheter aortic valve implantation: A meta‐analysis of 5,971 patients

<p>Acute kidney injury after transcatheter aortic valve replacement in the elderly: outcomes and risk management</p>

Transcatheter aortic valve replacement; a kidney’s perspective

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