Author + information
- Karim Al-Azizi1,
- Ahmed Alabbady2,
- Mobasser Mahmood2,
- Russell Carter2,
- Kimberly Skelding2 and
- Shikhar Agarwal2
Renal artery stenosis (RAS) has shown to be an adverse factor for developing Acute Kidney Injury (AKI). This relationship has not been evaluated in the context of TAVR.We aimed to evaluate on the relationship between RAS and AKI following TAVR.
302 patients underwent TAVR between 2011 and 2017. 6 patients with end-stage renal disease were excluded. We used propensity- matching analysis including age, sex, BMI, contrast volume, glomerular filtration rate and comorbidities to select matched pairs for analysis. AKI defined as an increase in serum creatinine by 0.3 mg/dl or more within 48 hrs or increase in serum creatinine to 1.5 times baseline or more within 7 days.CT angiograms of the abdomen were used to measure the minimum luminal diameter (MLD) and the average area at the ostium and the site of maximum stenosis in the renal arteries, proximal to any major branch. An area-stenosis of 60% or more was considered significant.
We obtained 43 matched pairs for analysis. AKI patients had significant diameter stenosis of at least one of the renal arteriesversus non AKI patients. (60.6 mm vs 47.76 mm, p=0.003). AKI patients had a significant area stenosis in at least one of their renal arteries (77 mm2 vs 67 mm2, p=0.006).Prevalence of bilateral RAS among the AKI cohort was 53.5%,versus 23.3% in controls (p=0.004). There was a trend towards statistical significance on comparison of any sided RAS in AKI cohort and controls (79.1% vs 62.8%, p=0.09).
RAS was associated with increased incidenceof AKI following TAVR. Patients withbilateral RAS had a statistically significant risk ofAKI compared to those without bilateral RAS.