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. 2018 Nov-Dec;33(6):559-566.
doi: 10.21470/1678-9741-2018-0137.

The Negative Effect of Mean Perfusion Pressure on the Development of Acute Kidney Injury after Transcatheter Aortic Valve Implantation

Ilker Gül  1 , Levent Cerit  1 , Bihter Senturk  2 , Mustafa Zungur  3 , Mustafa Beyazıt Alkan  4 , Hatice Kemal  1 , Zeynep Cerit  5 , Belma Yaman  1 , Songul Usalp  1 , Hamza Duygu  1
Affiliations

The Negative Effect of Mean Perfusion Pressure on the Development of Acute Kidney Injury after Transcatheter Aortic Valve Implantation

Ilker Gül et al. Braz J Cardiovasc Surg. 2018 Nov-Dec.

Abstract

Objective: To evaluate the predictive value of mean perfusion pressure (mPP) in the development of acute kidney injury (AKIN) after transcatheter aortic valve implantation (TAVI).

Methods: One hundred and forty seven consecutive patients with aortic stenosis (AS) were evaluated for this study and 133 of them were included. Mean arterial pressure (mAP) and central venous pressure (CVP) were used to calculate mPP before TAVI procedure (mPP = mAP-CVP). The occurrence of AKIN was evaluated with AKIN classification according to the Valve Academic Research Consortium-2 recommendations. The patients were divided into two groups according to the receiver operating characteristic (ROC) analysis of their mPP levels (high-risk group and low-risk group).

Results: The AKIN prevalence was 22.6% in this study population. Baseline serum creatinine level, glomerular filtration rate, amount of contrast medium, and the level of mPP were determined as predictive factors for the development of AKIN.

Conclusion: The occurrence of AKIN is associated with increased morbidity and mortality rates in patients with TAVI. In addition to the amount of contrast medium and basal kidney functions, our study showed that lower mPP was strongly associated with development of AKIN after TAVI.

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Conflict of interest statement

No conflict of interest.

Figures

Fig. 1
Fig. 1
ROC curve of mean perfusion pressure. The mean perfusion pressure value which can predict the acute kidney injury development was determined as 72 mmHg in ROC analysis [AUC: 0.813 (95% CI; 0.721-0.905); sensitivity, 72%; specificity, 84%]. AUC = area under the curve; CI = confidence interval; ROC = receiver operating characteristics.
Fig. 2
Fig. 2
Kaplan-Meier curves for overall survival in AKIN and non-AKIN (NRF) groups. AKIN = acute kidney injury; NRF = normal renal functions.
See this image and copyright information in PMC

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