ISSN : 1301-5680
e-ISSN : 2149-8156
TURKISH JOURNAL OF
THORACIC AND
CARDIOVASCULAR SURGERY
Turkish Journal of Thoracic and Cardiovascular Surgery     
Incidence, risk factors and prognostic impact of acute kidney injury on 30-day mortality after transcatheter aortic valve implantation
Selahattin Türen1, Aydın Yıldırım1, Muhammet Hulusi Satılmısoğlu1, Kürşad Öz2
1Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
2Department of Cardiovascular Surgery, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
DOI : 10.5606/tgkdc.dergisi.2017.14529
Background: This study aims to investigate the incidence, risk factors, and prognostic impact of acute kidney injury on 30-day mortality after transcatheter aortic valve implantation.

Methods: Between October 2010 and July 2012, 42 consecutive patients (15 males, 27 females; mean age 77.7±6.3 years; range 58 to 91 years) who underwent transcatheter aortic valve implantation in a single center were retrospectively analyzed. Acute kidney injury was defined according to the second consensus report of the Valve Academic Research Consortium definitions. Baseline, peri- and post-procedural characteristics were compared between the patients with and without acute kidney injury.

Results: Fourteen patients (33.3%) patients developed acute kidney injury, and two of them (14.3%) required temporary hemodialysis. Twenty patients (47.6%) had chronic kidney disease before the procedure. The incidence of chronic kidney injury was 71.4% and 35.7% in the patients with and without acute kidney injury, respectively (p<0.05). There was no statistically significant difference in the baseline creatinine levels of the two groups. In multivariable analyses, independent predictors of post-procedural acute kidney injury were post-procedural abnormal leukocyte count (OR: 2.52; 95% CI: 1.17-5.42) and low platelet count (OR: 1.05; 95% CI: 1.01-1.10). The 30-day mortality was 11.9% in five patients. The mortality rate was higher in the patients with acute kidney injury than those without (28.6% vs 3.6%, p<0.05).

Conclusion: Acute kidney injury following transcatheter aortic valve implantation occurred in 33.3% of our patient population and was found to be associated with an increased 30-day mortality rate. We also found that post-procedural abnormal leukocyte count and low platelet count were the independent predictors of acute kidney injury.

Keywords : Acute kidney injury; aortic stenosis; prognosis; transcatheter aortic valve implantation
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