Patient selection: Patients undergoing transcatheter AVR tended to be high risk surgical candidates unable to undergo standard surgical AVR. Many patients had some degree of chronic kidney disease.
Criteria for acute kidney injury - one or both of the following:
(1) decrease in estimated GFR by > 25% in the 48 hours following surgery
(2) ned for hemodialysis during the hospitalization
The risk of acute renal injury is greater with surgical aortic valve replacement than for transcatheter implantation. The risk of acute kidney injury was about 3 times higher (26% with standard surgery vs 9% for transcatheter AVR)..
Theoretical reasons for acute renal injury associated with transcatheter AVR:
(1) use of radiocontrast materials
(2) hypotension during the procedure
(3) atherosclerotic emboli dislodged by an intra-aortic catheter
Actual risk factors for acute renal injury associated with a transcatheter AVR:
(1) hypertension
(2) chronic obstructive pulmonary disease (COPD)
(3) peri-operative blood transfusion
