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International Journal of Nephrology
Volume 2012 (2012), Article ID 483748, 8 pages
http://dx.doi.org/10.1155/2012/483748
Clinical Study

The Risk of Acute Kidney Injury and Its Impact on 30-Day and Long-Term Mortality after Transcatheter Aortic Valve Implantation

1Division of Angiology, Department of Cardiovascular Medicine, University of Muenster, 48149 Muenster, Germany
2Division of Adult Congenital and Valvular Heart Disease, Department of Cardiovascular Medicine, University of Muenster, 48149 Muenster, Germany

Received 27 July 2012; Revised 7 November 2012; Accepted 3 December 2012

Academic Editor: Charuhas V. Thakar

Copyright © 2012 Katrin Gebauer et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Transcatheter aortic valve implantation (TAVI) is widely used in high risk patients (pts) with aortic stenosis. Underlying chronic kidney disease implicates a high risk of postprocedural acute kidney injury (AKI). We analyzed its occurrence, impact on hospital stay, and mortality. Methods. 150 consecutive pts underwent TAVI in our institution (mean age years; logistic EuroSCORE ). AKI definition was a creatinine rise of mol/L or more within 48 hours postprocedural. Ten patients on chronic hemodialysis were excluded. Results. AKI occurred in 28 pts (20%). Baseline creatinine was higher in AKI pts (126.4  59.2 mol/L versus 108.7  45.1 mol/L, ). Contrast media use was distributed evenly. Both, 30-day mortality (29% versus 7%, ) and long-term mortality (43% versus 18%, ) were higher; hospital stay was longer in AKI pts (20  12 versus 15  10 days, ). Predicted renal failure calculated STS Score was similar (8.0  5.0% [AKI] versus 7.1  4.0% [non-AKI], ) and estimated lower renal failure rates than observed. Conclusion. AKI remains a frequent complication with increased mortality in TAVI pts. Careful identification of risk factors and development of more suitable risk scores are essential.