Response in renal function after transcatheter tricuspid edge-to-edge repair

Chronic kidney disease (CKD) frequently coexists with heart failure (HF) and is associated with worse renal outcomes, due to venous congestion and reduced renal perfusion. In patients with severe tricuspid regurgitation (TR), transcatheter tricuspid edge-to-edge repair (T-TEER) can relieve symptoms, but its renal effects across CKD stages remain insufficiently defined. This study assessed changes in renal function, congestion markers, and acute kidney injury (AKI) before and after T-TEER.

This retrospective single-center study included 181 consecutive patients who underwent T-TEER at Robert Bosch Hospital Stuttgart between March 2021 and February 2023. Follow-up (median 125 days, IQR 6-506; up to 1280 days) was based on complete routine EHR (electronic health records) data. Patients with insufficient information were excluded.

Renal function improved significantly after T-TEER (median eGFR + 4.8 mL/min/1.73 m²; IQR 3.1;6.5; p < 0.001), accompanied by reductions in GGT and potassium. Improvements were observed across nearly all CKD stages, while patients with preserved baseline renal function (eGFR ≥ 60 mL/min/1.73 m²) remained stable. The incidence of AKI decreased markedly in all CKD groups (rate ratios 0.18-0.39; 60-80% reduction), and post-procedure AKI rates no longer differed between CKD stages.

Post-T-TEER, improvements in renal and congestion parameters were observed, accompanied by a lower incidence of AKI across CKD stages. These findings suggest a potential association between T-TEER and improvment in renal function and congestion. In patients with severe TR, T-TEER may be associated with preservation of kidney function and a reduced risk of AKI.