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Updated: Jan 3, 2026
Upper-extremity Approach for Secondary Access in Transfemoral Transcatheter Aortic Valve Implantation
Published on: August 8, 2025
Impact of Transcatheter Aortic Valve Implantation on Kidney Function
Rita Calça1, Rui C Teles2, Patrícia Branco1
1Nephrology department, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Lisboa - Portugal.
Insights
Transcatheter aortic valve implantation (TAVI) improved kidney function in patients with moderate-to-severe chronic kidney disease (CKD). This suggests a potential reversibility of renal dysfunction after TAVI due to enhanced kidney perfusion.
Area of Science:
- Cardiology
- Nephrology
- Interventional Cardiology
Background:
- Chronic kidney disease (CKD) often coexists with aortic valve disease.
- Reduced cardiac output in aortic valve disease can lead to decreased kidney perfusion and renal dysfunction.
Purpose of the Study:
- To evaluate the impact of transcatheter aortic valve implantation (TAVI) on kidney function in patients with varying degrees of CKD.
- To determine if kidney function improves after TAVI, particularly in those with moderate-to-severe CKD.
Main Methods:
- Retrospective analysis of 233 patients undergoing TAVI.
- Patients categorized into three groups based on baseline estimated glomerular filtration rate (eGFR): ≥ 60, 30-60, and < 30 mL/min/1.73 m2.
- eGFR assessed one month and one year post-TAVI using the CKD-EPI formula.
Main Results:
- Patients with eGFR < 60 mL/min/1.73 m2 showed significant improvement in kidney function one year after TAVI.
- Specifically, Group 3 (eGFR < 30) saw mean eGFR increase from 24.4 to 38.4 mL/min/1.73 m2.
- Patients with eGFR ≥ 60 experienced a progressive decline in kidney function post-TAVI.
Conclusions:
- TAVI can lead to improved kidney function in patients with moderate-to-severe CKD.
- Enhanced kidney perfusion following TAVI is the likely mechanism for this renal improvement.
- The potential for CKD reversal should be considered when assessing patients for TAVI.
Background:
Chronic kidney disease (CKD) is frequently present in patients with aortic valve disease. Decreased kidney perfusion as a consequence of reduced cardiac output may contribute to renal dysfunction in this setting.
Objective:
Given the potential reversibility of kidney hypoperfusion after valve repair, this study aimed to analyze the impact of percutaneous transcatheter aortic valve implantation (TAVI) on kidney function.
Methods:
We performed a retrospective analysis of 233 consecutive patients who underwent TAVI in a single center between November 2008 and May 2016. We assessed three groups according to their baseline estimated glomerular filtration rate (eGFR) (mL/min/1.73 m2): Group 1 with eGFR ≥ 60; Group 2 with 30 ≤ eGFR < 60; and Group 3 with eGFR < 30. We analyzed the eGFR one month and one year after TAVI in these three groups, using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formula to calculate it.
Results:
Patients from Group 1 had a progressive decline in eGFR one year after the TAVI procedure (p < 0.001 vs. pre-TAVI). In Group 2 patients, the mean eGFR increased one month after TAVI and continued to grow after one year (p = 0.001 vs. pre-TAVI). The same occurred in Group 3, with the mean eGFR increasing from 24.4 ± 5.1 mL/min/1.73 m2 before TAVI to 38.4 ± 18.8 mL/min/1.73 m2 one year after TAVI (p = 0.012).
Conclusions:
For patients with moderate-to-severe CKD, kidney function improved one year after the TAVI procedure. This outcome is probably due to better kidney perfusion post-procedure. We believe that when evaluating patients that might need TAVI, this 'reversibility of CKD effect' should be considered.
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