Acute kidney injury after Transcatheter aortic valve replacement: incidence, predictors and impact on mortality

Background: There is a paucity of data describing AKI following TAVR and their impact on mortality remained unknown. Methods: We searched Medline for studies from 2008 to 2013 evaluating AKI after TAVR. All studies were compared according to the incidence, predictors and impact of AKI following TAVR. AKI was defined according to the valve academic research consortium (VARC) indications using RIFLE criteria. Results: 13 studies with more than 1900 patients were included. AKI occured in 8.3% to 41.7%. Following factors were associated with AKI: blood transfusion, transapical access, preoperative creatinine, peripheral vascular disease, hypertension and procedural bleeding events. The 30-day mortality in patients with AKI ranged from 13.3 to 44.4% and was 2 to 6 times higher compared to patients without AKI. The contrast amount was not associated with the occurence of AKI. Conclusions: Acute kidney injury is a common complication occuring with an incidence of 8.3 to 41% in patients following TAVR. Patients with AKI exhibited a higher 30-day and late mortality. AKI was however, not related to the amount of contrast volume used.