Chronic kidney disease is associated with increased mortality and procedural complications in transcatheter aortic

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Pattara Rattanawong1,2, Chanavuth Kanitsoraphan1, Jakrin Kewcharoen1

  • 1Department of Internal Medicine, University of Hawaii Internal Medicine Residency Program, Honolulu, Hawaii.

Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions
|January 26, 2019
PubMed

Insights

Patients with chronic kidney disease (CKD) face higher mortality and procedural complication risks after transcatheter aortic valve replacement (TAVR). This risk escalates with CKD severity, highlighting a critical need for careful patient selection and management.

Area of Science:

  • Cardiology
  • Nephrology
  • Interventional Cardiology

Background:

  • Chronic kidney disease (CKD) significantly impacts cardiovascular health.
  • The specific risks associated with transcatheter aortic valve replacement (TAVR) in CKD patients remain unclear.
  • End-stage renal disease (ESRD) poses additional challenges in TAVR candidates.

Purpose of the Study:

  • To systematically review and meta-analyze the association between CKD and outcomes following TAVR.
  • To quantify the increased risk of mortality and procedural complications in CKD patients undergoing TAVR.
  • To explore the relationship between CKD severity and TAVR outcomes.

Main Methods:

  • Systematic literature search of MEDLINE and EMBASE databases up to May 2018.
  • Inclusion of published TAVR studies comparing CKD patients with control groups.
  • Meta-analysis using a random-effects model to combine data and assess risk ratios.

Main Results:

  • CKD patients exhibited significantly higher risks of 30-day and long-term mortality (overall and cardiovascular) post-TAVR.
  • Increased risks of procedural complications, including pacemaker requirement and bleeding, were observed in CKD patients.
  • Mortality and complication risks progressively increased with CKD severity (stages 3, 4, and 5).

Conclusions:

  • CKD is associated with a significantly elevated risk of mortality and procedural complications after TAVR.
  • The findings underscore the importance of considering CKD stage in TAVR risk assessment.
  • Further research may inform tailored management strategies for CKD patients undergoing TAVR.
Abstract

Keywords:
chronic kidney diseasetranscatheter aortic valve replacement

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