Acute Kidney Injury Following Transcatheter Aortic Valve Implantation: Association with Contrast Media Dosage and

Doron Sudarsky1,2, Yarden Drutin2, Fabio Kusniec1,2

  • 1The Department of Cardiology, The Lidya and Carol Kittner, Lea and Benjamin Davidai Division of Cardiovascular Medicine and Surgery, B. Padeh Medical Center, Poriya 1528001, Israel.

Insights

Contrast media (CM) dose before and during transcatheter aortic valve implantation (TAVI) does not impact kidney function. Acute kidney injury (AKI) risk models incorporating CM may be limited, with baseline eGFR being the key predictor.

Area of Science:

  • Cardiology
  • Nephrology
  • Radiology

Background:

  • The impact of contrast media (CM) on kidney function after transcatheter aortic valve implantation (TAVI) is unclear.
  • Existing acute kidney injury (AKI) risk prediction models using CM may have questionable performance.

Purpose of the Study:

  • To evaluate the association between CM dose and AKI post-TAVI.
  • To assess the predictive value of CM-based AKI risk models in TAVI patients.

Main Methods:

  • Retrospective study of 210 TAVI patients.
  • Recorded CM dose (pre- and during TAVI) and calculated AKI risk scores.
  • Assessed incidence of AKI and its correlation with CM dose and risk models.

Main Results:

  • AKI occurred in 18.1% of patients.
  • Lower baseline eGFR was observed in patients who developed AKI.
  • CM dose did not differ between AKI+ and AKI- groups, but risk model scores were higher in AKI+ patients.
  • Multivariable analysis identified only eGFR as an independent predictor of AKI.

Conclusions:

  • CM dose administered before or during TAVI is not associated with post-procedural AKI.
  • The predictive utility of CM-based AKI risk models in TAVI appears limited, primarily reflecting baseline eGFR.

Related Concept Videos

Acute Kidney Injury IV: Diagnostic Studies and Prevention01:30

Acute Kidney Injury IV: Diagnostic Studies and Prevention

Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
69
Cardiac Catheterization I: Pre-Procedure Overview01:28

Cardiac Catheterization I: Pre-Procedure Overview

Cardiac catheterization is an invasive diagnostic technique used to identify and evaluate structural and functional diseases of the heart and major blood vessels. This technique diagnoses congenital heart disease, coronary artery disease, valvular heart disease, and coronary spasms and assesses ventricular function. It helps guide treatment decisions, including the need for revascularization procedures like percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) and...
223
Imaging Studies VII: Vascular Imaging01:19

Imaging Studies VII: Vascular Imaging

DefinitionRenal angiography, also known as renal arteriography, is an imaging technique used to obtain a comprehensive view of blood flow and the vascular structure of blood vessels in the kidneys and surrounding areas.PurposeRenal angiography detects blood vessel abnormalities in the kidneys, such as aneurysms, stenosis, thrombosis, vascular tumors, and renal artery stenosis. It evaluates kidney function and guides interventional treatments like angioplasty or stent placement.Pre-Procedure...
82
Acute Kidney Injury I: Introduction01:22

Acute Kidney Injury I: Introduction

Introduction:Acute Kidney Injury (AKI) describes a swift decrease in kidney function occurring over hours to days, characterized by the kidneys' failure to remove waste products from the bloodstream. This leads to dangerous complications like metabolic acidosis, fluid overload, and electrolyte imbalances, such as hyperkalemia, which can cause life-threatening arrhythmias. AKI is common in both hospital and outpatient settings, often triggered by dehydration, sepsis, or exposure to nephrotoxic...
116
Acute Kidney Injury II: Pathophysiology01:29

Acute Kidney Injury II: Pathophysiology

Acute kidney injury (AKI) causes are categorized into three primary categories based on the location of the injury: prerenal, intrarenal (or intrinsic), and postrenal causes. This classification guides clinical management and illustrates how different pathways can impair kidney function.Etiology and Pathophysiology of Acute Kidney Injury1. Prerenal causesEtiology: Prerenal Acute Kidney Injury, the most common type, occurs when reduced blood flow to the kidneys decreases filtration capacity...
136
Acute Kidney Injury V: Interprofessional Care01:20

Acute Kidney Injury V: Interprofessional Care

Acute Kidney Injury (AKI) requires a collaborative healthcare approach to restore renal function and prevent complications. Essential management strategies involve monitoring fluid and electrolyte balance, adjusting medications, initiating dialysis when necessary, and providing nutritional support.Fluid and Electrolyte ManagementFluid Monitoring: Regularly monitoring body weight, central venous pressure, and urine output helps detect fluid imbalances early. Patient intake and output are...
62