Wisit Cheungpasitporn
1, Charat Thongprayoon
2, Kianoush Kashani
3*1 Division of Nephrology and Hypertension, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA
2 Department of Internal Medicine, Bassett Medical Center, Cooperstown, NY, USA
3 Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA
Abstract
Transcatheter aortic valve replacement (TAVR) has now emerged as a viable treatment option for high-risk patients with severe aortic stenosis (AS) who are not suitable candidates for surgical aortic valve replacement (SAVR). Despite encouraging published outcomes, acute kidney injury (AKI) is common and lowers the survival of patients after TAVR. The pathogenesis of AKI after TAVR is multifactorial including TAVR specific factors such as the use of contrast agents, hypotension during rapid pacing, and embolization; preventive measures may include pre-procedural hydration, limitation of contrast dye exposure, and avoidance of intraprocedural hypotension. In recent years, the number of TAVR performed worldwide has been increasing, as well as published data on renal perspectives of TAVR including AKI, chronic kidney disease, end-stage kidney disease, and kidney transplantation. This review aims to present the current literature on the nephrology aspects of TAVR, ultimately to improve the patients’ quality of care and outcomes.
Implication for health policy/practice/research/medical education:
Transcatheter aortic valve replacement (TAVR) has now emerged as a viable treatment option for high-risk patients with severe aortic stenosis (AS) who are not suitable candidates for surgical aortic valve replacement (SAVR). Despite encouraging published outcomes, acute kidney injury (AKI) after TAVR is common and lowers the survival of patients after TAVR. In recent years, the number of TAVR performed worldwide have been increasing as well as published data on renal perspectives of TAVR including AKI, chronic kidney disease, end-stage kidney disease and kidney transplantation. We present the current literature on nephrology aspects of TAVR, ultimately to improve the patients’ quality of care and outcomes.
Please cite this paper as: Cheungpasitporn W, Thongprayoon C, Kashani K. Transcatheter aortic valve replacement; a kidney’s perspective. J Renal Inj Prev. 2016;5(1):1-7. DOI: 10.15171/jrip.2016.01