Transcatheter aortic valve replacement in patients with chronic kidney disease: a multi-centre retrospective study

Al Jarallah M 1 , Abdulsalam S 2 , Rajan R 1 , Dashti R 1 , Zhanna KD 3 , Setiya P 4 Show all authors , Al-Saber A 5 , Alajmi M 2 , Brady PA 6 , Luisa Baca G 7 , Al Balool J 8 , Tse G 9

Affiliations 

  • 1 Department of Cardiology, Sabah Al Ahmed Cardiac Centre, Al Amiri Hospital, Kuwait City, Kuwait
  • 2 Faculty of Medicine, Royal College of Surgeons Ireland, Dublin, Ireland
  • 3 Department of Internal Medicine with the Subspecialty of Cardiology and Functional Diagnostics Named after V.S. Moiseev, Institute of Medicine, Peoples' Friendship University of Russia (RUDN University), Moscow, Russian Federation
  • 4 Department of Agrometeorology, College of Agriculture, G.B. Pant University of Agriculture & Technology, Pantnagar, Uttarakhand, India
  • 5 Department of Mathematics and Statistics, University of Strathclyde, Glasgow, UK
  • 6 Department of Cardiology, Illinois Masonic Medical Center, Chicago, IL
  • 7 Department of Intramural Research Program, Laboratory of Cardiovascular Science, National Institute on Aging, National Institutes of Health, Baltimore, MD
  • 8 Department of Medicine, Kuwait University, Jabria, Kuwait
  • 9 Cardiovascular Analytics Group, Hong Kong, China
Ann Med Surg (Lond), 2024 Feb;86(2):697-702.
PMID: 38333245 DOI: 10.1097/MS9.0000000000001590

Abstract

BACKGROUND: Chronic kidney disease (CKD) is a common comorbid condition in patients undergoing transcatheter aortic valve replacement (TAVR). Reported outcome studies on the association of baseline CKD and mortality is currently limited.

OBJECTIVES: To determine the prevalence of chronic kidney disease in patients undergoing TAVR and analyse their overall procedural outcomes.

METHODS: This retrospective observational study was conducted at 43 publicly funded hospitals in Hong Kong. Severe aortic stenosis patients undergoing TAVR between the years 2010 and 2019 were enroled in the study. Two groups were identified according to the presence of baseline chronic kidney disease.

RESULTS: A total of 499 patients (228, 58.6% men) were enroled in the study. Baseline hypertension was more prevalent in patients with CKD (82.8%; P=0.003). As for primary end-points, mortality rates of CKD patients were significantly higher compared to non-CKD patients (10% vs. 4.1%; P=0.04%). Gout and hypertension were found to be significantly associated with CRF. Patients with gout were nearly six times more likely to have CRF than those without gout (odds ratio = 5.96, 95% CI = 3.12-11.29, P<0.001). Patients with hypertension had three times the likelihood of having CRF compared to those without hypertension (odds ratio=2.83, 95% CI=1.45-6.08, P=0.004).

CONCLUSION: In patients with severe aortic stenosis undergoing TAVR, baseline CKD significantly contributes to mortality outcomes at long-term follow up.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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