Related Experiment Video
Updated: Jun 10, 2026
Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure
Published on: February 8, 2022
Response in renal function after transcatheter tricuspid edge-to-edge repair
Mathias Becker1, L Kraft2, T Oberacker3
1Department of Cardiology and Angiology, Robert Bosch Hospital, Auerbachstr. 110, 70376, Stuttgart, Germany. mathias.becker@rbk.de.
Insights
Transcatheter tricuspid edge-to-edge repair (T-TEER) improved kidney function and reduced acute kidney injury (AKI) in patients with chronic kidney disease (CKD). These benefits were seen across various CKD stages following the procedure for severe tricuspid regurgitation.
Area of Science:
- Cardiology
- Nephrology
- Interventional Cardiology
- Renal Medicine
Background:
- Chronic kidney disease (CKD) often coexists with heart failure (HF), worsening renal outcomes due to congestion and reduced perfusion.
- Transcatheter tricuspid edge-to-edge repair (T-TEER) is used for severe tricuspid regurgitation (TR) but its impact on renal function across CKD stages is unclear.
Purpose of the Study:
- To assess the effects of T-TEER on renal function, congestion markers, and acute kidney injury (AKI) in patients with CKD.
- To evaluate renal outcomes following T-TEER across different stages of chronic kidney disease.
Main Methods:
- Retrospective single-center study of 181 patients undergoing T-TEER between March 2021 and February 2023.
- Analysis of routine electronic health records for renal function (eGFR), congestion markers, and AKI incidence pre- and post-procedure.
- Patients were stratified by baseline renal function (CKD stages).
Main Results:
- Significant improvement in median estimated glomerular filtration rate (eGFR) by +4.8 mL/min/1.73 m² post-T-TEER (p < 0.001).
- Reduced incidence of AKI across all CKD groups (60-80% reduction), with no difference in post-procedure AKI rates between stages.
- Improvements in renal function and congestion markers (GGT, potassium) observed across most CKD stages.
Conclusions:
- T-TEER is associated with improved renal function and congestion parameters in patients with severe TR and CKD.
- The procedure may help preserve kidney function and reduce the risk of AKI in this patient population.
- Findings suggest T-TEER is a viable option for patients with coexisting severe TR and CKD.
Background:
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.
Methods:
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.
Results:
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.
Conclusions:
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.
