Acute kidney injury after TAVR: Key risk factors every cardiologist should know
Acute kidney injury (AKI) remains a relatively common complication after transcatheter aortic valve replacement (TAVR), and multiple studies have linked it to a heightened risk of short- or long-term mortality. To learn more about the various risk factors associated with post-TAVR AKI, a research team out of China performed a large meta-analysis of more than 10,000 patients originally treated as part of 34 different studies. The group published its results in full in Frontiers in Cardiovascular Medicine.[1]
“Reported risk factors for AKI following TAVR vary considerably across studies, with no clear consensus,” wrote first author Nan Jiang, a researcher with the department of cardiology at the First People’s Hospital of Zigong in Sichuan, China, and colleagues. “A better understanding and recognition of these factors, along with the implementation of targeted preventive strategies, may help improve survival and clinical outcomes in patients undergoing TAVR.”
Jiang et al. focused on data from a total of 10,353 patients who underwent TAVR from 2009 to 2024. Patients underwent treatment in a variety of countries, including the United States, Australia, Germany, Brazil and Italy. Mean ages for the 34 studies included in this meta-analysis ranged from 70 years old to 83 years old.
Overall, 21.7% of TAVR patients went on to develop AKI. The authors used multivariable pooling to identify eight different independent predictors of AKI after TAVR: hypertension, coronary artery disease, peripheral vascular disease, prior stroke, chronic kidney disorder, elevated serum creatinine levels, higher Society of Thoracic Surgeons risk scores and the use of transapical access during the TAVR procedure. In addition, the group turned to univariate analyses and identified other potential risk factors, including diabetes, prior percutaneous coronary intervention, atrial fibrillation, left ventricular ejection fraction less than 40%, the use of diuretics, the use of general anesthesia, rapid pacing and periprocedural myocardial infarction or stroke.
“Early recognition, diagnosis, and intervention based on these predictors may improve patient outcomes,” the authors wrote. “Given the limited number and variable quality of available studies, further high-quality research is required to confirm these findings.”
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Michael has more than 19 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.