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. 2020 Oct 28;9(11):3476.
doi: 10.3390/jcm9113476.

Evaluating the Association between Contrast Medium Dosage and Acute Kidney Injury in Transcatheter Aortic Valve Replacement Using Different Predictive Models

Markus Mach  1   2 , Waseem Hasan  3 , Martin Andreas  1 , Bernhard Winkler  2 , Gabriel Weiss  2 , Christopher Adlbrecht  4 , Georg Delle-Karth  4 , Martin Grabenwöger  2   5
Affiliations

Evaluating the Association between Contrast Medium Dosage and Acute Kidney Injury in Transcatheter Aortic Valve Replacement Using Different Predictive Models

Markus Mach et al. J Clin Med. .

Abstract

Recent studies have suggested that contrast medium (CM) volume is associated with acute kidney injury (AKI) after transcatheter aortic valve replacement (TAVR). However, in a high-risk elderly TAVR population, the prognostic value and ideal threshold of CM dosage for AKI is unclear. Data of 532 successive TAVR patients (age 81.1 ± 6.8 years, EuroSCORE II 4.8% ± 6.0%) were therefore retrospectively analyzed. Based on a recently published formula, the renal function (preprocedural serum creatinine: SCr) corrected ratio of CM and body weight (CM*SCr/BW) was calculated to determine the risk of postprocedural contrast-associated AKI. AKI occurred in 94 patients (18.3%) and significantly increased 1-year all-cause mortality (23.4% vs. 13.1%; p = 0.001). A significant correlation between AKI and 30-day as well as 1-year all-cause mortality was observed (p = 0.001; p = 0.007). However, no association between CM dosage or the CM*SCr/BW ratio with the occurrence of AKI was seen (p = 0.968; p = 0.442). In our all-comers, all-access cohort, we found no relationship between CM dosage, or the established risk ratio model and the occurrence of postprocedural AKI. Further research needs to be directed towards different pathophysiological causes and preventive measures as AKI impairs short- and long-term survival.

Keywords: AKI; TAVR; contrast medium; mortality; renal function.

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Conflict of interest statement

M.M. has received a research grant from Edwards Lifesciences, JenaValve, and Symetis. M.A. is proctor (Abbott, Edwards) and advisor (Medtronic). All other authors have reported that they have no relationships relevant to the content. Edwards Lifesciences, JenaValve, Symetis, Abbott Laboratories, and Medtronic had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

Figures

Figure 1
Figure 1
Risk Stratification Score Model designed by Mehran et al. to predict contrast induced nephropathy (CIN) following percutaneous coronary intervention (PCI) [7].
Figure 2
Figure 2
Average CM dosage administered to patients who developed different stages of AKI.
Figure 3
Figure 3
Survival of AKI and non-AKI patients at one year after adjusting for confounders.
See this image and copyright information in PMC

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