• J García-Lara, E Pinar-Bermúdez, J R Gimeno-Blanes, J Lacunza-Ruiz, J A Hurtado Martinez, R Valdesuso-Aguilar, and M Valdés-Chávarri.
• Unidad de Hemodinamica- Servicio de Cardiologia, Hospital Universitario Virgen de la Arrixaca, Carretera Cartagena SN 30110 Murcia, Spain. jgarciadelara@gmail.com.
• J Invasive Cardiol. 2014 Apr 1; 26 (4): 183-6.

BackgroundAcute kidney injury is a common complication after surgical aortic replacement and entails a worse prognosis. Percutaneous valve implantation is an alternative to surgical replacement. We sought to elucidate incidence, predictors, and effects of acute kidney injury after percutaneous aortic valve implantation.MethodsA cohort of consecutive patients who underwent percutaneous aortic valve implantation at one center were studied, excluding those who died in the first 24 hours and those on prior hemodialysis.ResultsA total of 131 patients (age, 80.8 ± 6 years; 42% male; Euroscore II, 10.27 ± 6.9) were included. Acute kidney injury was defined as a reduction >25% in glomerular filtration rate (GFR). GFR was 62.09 ± 22 mL/min/1.73 m² at baseline, 62.7 ± 25 mL/min/1.73 m² after the procedure, and 68.03 ± 25 mL/min/1.73 m² at discharge. Acute kidney injury appeared in 17 patients (13%). Of these, 11 recovered and only 6 (4.5%) showed impaired GFR >25% upon discharge. Patients with acute kidney injury showed longer hospitalization length (median 7 days [IQR, 5-12 days] vs 3 days [IQR, 2-6 days]; P=.01) and higher 30-day mortality rate (17.6% vs 0.9%; P=.01). The only independent predictor for acute kidney injury development was Euroscore II (odds ratio, 1.192; confidence interval, 1.042-1.326; P=.01).ConclusionIncidence of acute kidney injury after transcatheter aortic valve implantation was 13% in our cohort. Patients with acute kidney injury showed longer hospitalization and higher 30-day mortality rate. Euroscore II was an independent predictor of acute kidney injury.

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