Kidney function change after transcatheter aortic valve replacement in patients with diabetes and/or hypertension

Abstract

Aortic stenosis (AS) is a progressive heart valve disease occurring predominantly in older patients. According to a survey in a western country, the prevalence of AS is nearly 6.4% in patients over 75 years old (Carabello and Paulus, 2009). Transcatheter aortic valve replacement (TAVR) is an alternative method for AS patients. Previous studies have described how up to 66% of TAVR patients have concomitant baseline kidney dysfunction (Ferro et al., 2015; Gargiulo et al., 2015). The majority of patients can benefit from the TAVR procedure with the recovery of kidney function. The TAVR procedure releases the obstruction of the left ventricle caused by severe AS, and the increased cardiac output may be reasonably responsible for recovery of the kidney function (Ewe et al., 2010; Dauerman et al., 2016). Kidney dysfunction is most commonly attributed to diabetes and hypertension (HTN) (Chen et al., 2019). A few studies have reported kidney function change after TAVR in baseline chronic kidney disease (CKD) patients (Beohar et al., 2017; Azarbal et al., 2019; Okoh et al., 2019). However, no study has focused on kidney function change after TAVR in the diabetic or hypertensive population. Therefore, we aimed to investigate kidney function change during the TAVR procedure in patients with diabetes mellites (DM) and/or HTN.

Fig. 1. Percentages of estimated glomerular filtration rate (eGFR) changes in diabetic and/or hypertensive patients versus non-diabetic and non-hypertensive patients.