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Acute kidney recovery in patients undergoing transcatheter vs surgical aortic valve replacement (from the Northern New England Cardiovascular Disease Study Group)

The American Journal of Cardiology Dec 18, 2019

Lahoud R, Butzel DW, Parsee A, et al. - By analyzing patients with chronic kidney disease and severe aortic stenosis undergoing surgical aortic valve replacement (SAVR) or transcatheter aortic valve replacement (TAVR) procedure between 2007-2017, researchers examined the incidence as well as predictors of acute kidney recovery (AKR) between SAVR and TAVR. Cases with age < 65 or > 90, dialysis, endocarditis, non-aortic valve stenosis, or patients died within 48-hours post-procedure were removed from this study. A rise of estimated glomerular filtration rate (eGFR) > 25% and a reduction in eGFR > 25% at discharge defined AKR and acute kidney injury (AKI), respectively. They noted AKR in 26% TAVR compared with 23.2% SAVR. Ejection fraction < 50%, female gender, and obesity were identified as independent predictors of AKR. Improved secondary clinical outcomes were reported in relation to AKR vs AKI. Overall, AKR was acknowledged as a generalizable phenomenon, with a frequent and similar occurrence noted in transcatheter or surgical aortic valve patients. Diabetes was identified as a negative predictor of AKR, probably suggestive of less reversible kidney disease.
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