Kidney Week

Abstract: FR-PO485

Impact of Transcatheter Aortic Valve Implantation on Renal Function

Session Information

• CKD: Epidemiology, Outcomes - Cardiovascular - II
  November 03, 2017 | Location: Hall H, Morial Convention Center
  Abstract Time: 10:00 AM - 10:00 AM

Category: Chronic Kidney Disease (Non-Dialysis)

• 303 CKD: Epidemiology, Outcomes - Cardiovascular

Authors

• Calça, Rita, Hospital Santa Cruz, Lisboa, Portugal

Rita Calça,

• Teles, Rui C, Hospital Santa Cruz, Lisboa, Portugal

Rui C Teles,

• Branco, Patricia Quadros, Hospital Santa Cruz, Lisboa, Portugal

Patricia Quadros Branco,

• Brito, João, Hospital Santa Cruz, Lisboa, Portugal

João Brito,

• Nolasco, Tiago, Hospital Santa Cruz, Lisboa, Portugal

Tiago Nolasco,

• Almeida, Manuel De sousa, Hospital Santa Cruz, Lisboa, Portugal

Manuel De sousa Almeida,

• Neves, José Pedro, Hospital Santa Cruz, Lisboa, Portugal

José Pedro Neves,

• Mendes, Miguel, Hospital Santa Cruz, Lisboa, Portugal

Miguel Mendes,

• Machado, Domingos Silveira, Hospital Santa Cruz, Lisboa, Portugal

Domingos Silveira Machado,

• Weigert, Andre L., Hospital Santa Cruz, Lisboa, Portugal

Andre L. Weigert,

Background

Chronic kidney disease (CKD) is very prevalent in patients with aortic valve disease. Decreased renal perfusion as a consequence of diminished cardiac output may contribute to this patient's renal disfuncion. Given the potential reversibility of this mechanism after valve correction, the aim of this study was to verify the impact of percutaneous transcatether aortic implantation (TAVI) on kidney function.

Methods

We performed a retrospective analysis of 233 consecutive patients that underwent TAVI and were included in single center prospective registry between November 2008 and May 2017. Estimated Glomerular Filtration Rate (eGFR) was calculated using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formula and we considered 3 groups according their eGFR (mL/min/1.73 m²); the categories sugested by Kidney Disease Improving Global Outcomes (KDIGO) 2012 guidelines were mentioned for each group. Group 1 with eGFR≥60 included patients without CKD or CKD G1-2; Group 2 with 30≤eGFR<60 (CKD G3a-b); and Group 3 with eGFR<30 (CKD G4). Patients on dialysis were excluded from the analysis. Previous to TAVI, 43,1% were in Group 1, 44,0% in Group 2 and the remaining 12,9% in Group 3.

Results

56.7% were female and the mean age was 81.8±7.5years (from 47 to 94years). No age or gender differences were found between groups. In patients from Group 1, a 15% fall in eGFR was verified after 1year follow-up (table1). Conversely, in patients from Group 2 and Group 3 we observed a significant increase in eGFR after TAVI (table1).

Conclusion

The association between worse outcomes in CKD patients undergoing TAVI is well established, but little is known about the potential reversibility of renal function after aortic valve replacement. We concluded that, for patients with moderate-to-severe CKD, there is a gain of function in the first month post-TAVI, which increased further 1 year after the procedure. This is probably due to improved renal perfusion post-procedure. We postulate that when evaluating patients that might need TAVI, this ‘reversibility of CKD effect’ should be considered.

Table 1