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Chronic kidney disease and transcatheter aortic valve implantation

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Abstract

Transcatheter aortic valve implantation (TAVI) is an established treatment option for patients with severe aortic stenosis. Patients with aortic stenosis have a higher prevalence of chronic kidney disease (CKD). CKD is generally associated with an increased risk of mortality, cardiovascular events, and readmission for heart failure; this supports the concept of a cardio-renal syndrome (CRS). CRS encompasses a spectrum of disorders of the heart and kidneys, wherein dysfunction in one organ may cause dysfunction in the other. TAVI treatment is expected to break this malignant cycle of CRS and improve cardio-renal function after the procedure. However, several reports demonstrate that patients with CKD have been associated with poor outcomes after the procedure. In addition, TAVI treatments for patients with advanced CKD and those with end-stage renal disease on hemodialysis are considered more challenging. Adequate management to preserve cardio-renal function in patients undergoing TAVI may reduce the risk of cardio-renal adverse events and improve the long-term prognosis. The current comprehensive review article aims to assess the prognostic impact of CKD after TAVI and seek optimal care in patients with CKD even after successful TAVI.

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References

  1. Leon MB, Smith CR, Mack M, Miller DC, Moses JW, Svensson LG, et al. Transcatheter aortic-valve implantation for aortic stenosis in patients who cannot undergo surgery. N Engl J Med. 2010;363:1597–15607. https://doi.org/10.1056/NEJMoa1008232.

    Article  CAS  PubMed  Google Scholar 

  2. Smith CR, Leon MB, Mack MJ, Miller DC, Moses JW, Svensson LG, et al. Transcatheter versus surgical aortic-valve replacement in high-risk patients. N Engl J Med. 2011;364:2187–98. https://doi.org/10.1056/NEJMoa1103510.

    Article  CAS  PubMed  Google Scholar 

  3. Leon MB, Smith CR, Mack MJ, Makkar RR, Svensson LG, Kodali SK, et al. Transcatheter or surgical aortic-valve replacement in intermediate-risk patients. N Engl J Med. 2016;374:1609–20. https://doi.org/10.1056/NEJMoa1514616.

    Article  CAS  PubMed  Google Scholar 

  4. Mack MJ, Leon MB, Thourani VH, Makkar R, Kodali SK, Russo M, et al. Transcatheter aortic-valve replacement with a balloon-expandable valve in low-risk patients. N Engl J Med. 2019;380:1695–705. https://doi.org/10.1056/NEJMoa1814052.

    Article  PubMed  Google Scholar 

  5. Yamamoto M, Hayashida K, Mouillet G, Hovasse T, Chevalier B, Oguri A, et al. Prognostic value of chronic kidney disease after transcatheter aortic valve implantation. J Am Coll Cardiol. 2013;62:869–77. https://doi.org/10.1016/j.jacc.2013.04.057.

    Article  PubMed  Google Scholar 

  6. Oguri A, Yamamoto M, Mouillet G, Gilard M, Laskar M, Eltchaninoff H, et al. Impact of chronic kidney disease on the outcomes of transcatheter aortic valve implantation: results from the FRANCE 2 registry. EuroIntervention. 2015;10:e1–9. https://doi.org/10.4244/EIJV10I9A183.

    Article  PubMed  Google Scholar 

  7. Codner P, Levi A, Gargiulo G, Praz F, Hayashida K, Watanabe Y, et al. Impact of renal dysfunction on results of transcatheter aortic valve replacement outcomes in a large multicenter cohort. Am J Cardiol. 2016;118:1888–96. https://doi.org/10.1016/j.amjcard.2016.08.082.

    Article  PubMed  Google Scholar 

  8. Gracia E, Wang TY, Callahan S, Bilfinger T, Tannous H, Pyo R, et al. Impact of severity of chronic kidney disease on management and outcomes following transcatheter aortic valve replacement with newer-generation transcatheter valves. J Invas Cardiol. 2020;32:25–9.

    Google Scholar 

  9. Franzone A, Stortecky S, Pilgrim T, Asami M, Lanz J, Heg D, et al. Incidence and impact of renal dysfunction on clinical outcomes after transcatheter aortic valve implantation. Int J Cardiol. 2018;250:73–9. https://doi.org/10.1016/j.ijcard.2017.09.201.

    Article  PubMed  Google Scholar 

  10. Gupta T, Goel K, Kolte D, Khera S, Villablanca PA, Aronow WS, et al. Association of chronic kidney disease with in-hospital outcomes of transcatheter aortic valve replacement. JACC Cardiovasc Intv. 2017;10:2050–60. https://doi.org/10.1016/j.jcin.2017.07.044.

    Article  Google Scholar 

  11. Adachi Y, Yamamoto M, Shimura T, Yamaguchi R, Kagase A, Tokuda T, et al. Late kidney injury after transcatheter aortic valve replacement. Am Heart J. 2021;234:122–30. https://doi.org/10.1016/j.ahj.2021.01.007.

    Article  CAS  PubMed  Google Scholar 

  12. Beohar N, Doshi D, Thourani V, Jensen H, Kodali S, Zhang F, et al. Association of transcatheter aortic valve replacement with 30-day renal function and 1-year outcomes among patients presenting with compromised baseline renal function: experience from the PARTNER 1 trial and registry. JAMA Cardiol. 2017;2:742–9. https://doi.org/10.1001/jamacardio.2017.1220.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Witberg G, Steinmetz T, Landes U, Pistiner Hanit R, Green H, Goldman S, et al. Change in kidney function and 2-year mortality after transcatheter aortic valve replacement. JAMA Netw Open. 2021;4: e213296. https://doi.org/10.1001/jamanetworkopen.2021.3296.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Cubeddu RJ, Asher CR, Lowry AM, Blackstone EH, Kapadia SR, Alu MC, et al. Impact of transcatheter aortic valve replacement on severity of chronic kidney disease. J Am Coll Cardiol. 2020;76:1410–21. https://doi.org/10.1016/j.jacc.2020.07.048.

    Article  PubMed  Google Scholar 

  15. Liao YB, Deng XX, Meng Y, Zhao ZG, Xiong TY, Meng XJ, et al. Predictors and outcome of acute kidney injury after transcatheter aortic valve implantation: a systematic review and meta-analysis. EuroIntervention. 2017;12:2067–74. https://doi.org/10.4244/EIJ-D-15-00254.

    Article  PubMed  Google Scholar 

  16. Najjar M, Salna M, George I. Acute kidney injury after aortic valve replacement: incidence, risk factors and outcomes. Expert Rev Cardiovasc Ther. 2015;13:301–16. https://doi.org/10.1586/14779072.2015.1002467.

    Article  CAS  PubMed  Google Scholar 

  17. Yamamoto M, Hayashida K, Mouillet G, Chevalier B, Meguro K, Watanabe Y, et al. Renal function-based contrast dosing predicts acute kidney injury following transcatheter aortic valve implantation. JACC Cardiovasc Interv. 2013;6:479–86. https://doi.org/10.1016/j.jcin.2013.02.007.

    Article  PubMed  Google Scholar 

  18. Thongprayoon C, Cheungpasitporn W, Gillaspie EA, Greason KL, Kashani KB. The risk of acute kidney injury following transapical versus transfemoral transcatheter aortic valve replacement: a systematic review and meta-analysis. Clin Kidney J. 2016;9:560–6. https://doi.org/10.1093/ckj/sfw055.

    Article  PubMed  PubMed Central  Google Scholar 

  19. National Kidney Foundation. K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Am J Kidney Dis. 2002;39(Suppl 1):S1–266.

    Google Scholar 

  20. Ronco C, McCullough P, Anker SD, Anand I, Aspromonte N, Bagshaw SM, et al. Cardio-renal syndromes: report from the consensus conference of the acute dialysis quality initiative. Eur Heart J. 2010;31:703–11. https://doi.org/10.1093/eurheartj/ehp507.

    Article  PubMed  Google Scholar 

  21. Rangaswami J, Bhalla V, Blair JEA, Chang TI, Costa S, Lentine KL, et al. Cardiorenal syndrome: classification, pathophysiology, diagnosis, and treatment strategies: A scientific statement from the American Heart Association. Circulation. 2019;139:e840–78. https://doi.org/10.1161/CIR.0000000000000664.

    Article  PubMed  Google Scholar 

  22. Ronco C, Haapio M, House AA, Anavekar N, Bellomo R. Cardiorenal syndrome. J Am Coll Cardiol. 2008;52:1527–39. https://doi.org/10.1016/j.jacc.2008.07.051.

    Article  PubMed  Google Scholar 

  23. Vavilis G, Bäck M, Occhino G, Trevisan M, Bellocco R, Evans M, et al. Kidney dysfunction and the risk of developing aortic stenosis. Am J Cardiol. 2022;163:58–64.

    Article  CAS  Google Scholar 

  24. D’Ascenzo F, Moretti C, Salizzoni S, Bollati M, D’Amico M, Ballocca F, et al. 30 days and midterm outcomes of patients undergoing percutaneous replacement of aortic valve according to their renal function: a multicenter study. Int J Cardiol. 2013;167:1514–8. https://doi.org/10.1016/j.ijcard.2012.04.161.

    Article  PubMed  Google Scholar 

  25. Dumonteil N, van der Boon RM, Tchetche D, Chieffo A, Van Mieghem NM, Marcheix B, et al. Impact of preoperative chronic kidney disease on short- and long-term outcomes after transcatheter aortic valve implantation: a Pooled-RotterdAm-Milano-Toulouse In Collaboration Plus (PRAGMATIC-Plus) initiative substudy. Am Heart J. 2013;165:752–60. https://doi.org/10.1016/j.ahj.2012.12.013.

    Article  PubMed  Google Scholar 

  26. Nguyen TC, Babaliaros VC, Razavi SA, Kilgo PD, Guyton RA, Devireddy CM, et al. Impact of varying degrees of renal dysfunction on transcatheter and surgical aortic valve replacement. J Thorac Cardiovasc Surg. 2013;146:1399–13406. https://doi.org/10.1016/j.jtcvs.2013.07.065 (discussion 13406–7).

    Article  PubMed  Google Scholar 

  27. Ferro CJ, Chue CD, de Belder MA, Moat N, Wendler O, Trivedi U, et al. Impact of renal function on survival after transcatheter aortic valve implantation (TAVI): an analysis of the UK TAVI registry. Heart. 2015;101:546–52. https://doi.org/10.1136/heartjnl-2014-307041.

    Article  PubMed  Google Scholar 

  28. Nijenhuis VJ, Peper J, Vorselaars VMM, Swaans MJ, De Kroon T, Van der Heyden JAS, et al. Prognostic value of improved kidney function after transcatheter aortic valve implantation for aortic stenosis. Am J Cardiol. 2018;121:1239–45. https://doi.org/10.1016/j.amjcard.2018.01.049.

    Article  PubMed  Google Scholar 

  29. Azarbal A, Leadholm KL, Ashikaga T, Solomon RJ, Dauerman HL. Frequency and prognostic significance of acute kidney recovery in patients who underwent transcatheter aortic valve implantation. Am J Cardiol. 2018;121:634–41. https://doi.org/10.1016/j.amjcard.2017.11.043.

    Article  PubMed  Google Scholar 

  30. VARC-3 Writing Committee, Généreux P, Piazza N, Alu MC, Nazif T, Hahn RT, et al. Valve Academic Research Consortium 3: updated endpoint definitions for aortic valve clinical research. Eur Heart J. 2021;42:1825–57. https://doi.org/10.1093/eurheartj/ehaa799.

    Article  Google Scholar 

  31. Yamamoto M, Watanabe Y, Tada N, Naganuma T, Araki M, Yamanaka F, et al. Transcatheter aortic valve replacement outcomes in Japan: optimized CathEter valvular iNtervention (OCEAN) Japanese multicenter registry. Cardiovasc Revasc Med. 2019;20:843–51. https://doi.org/10.1016/j.carrev.2018.11.024.

    Article  PubMed  Google Scholar 

  32. Adachi Y, Yamamoto M, Shimura T, Yamaguchi R, Kagase A, Tokuda T, et al. Late adverse cardiorenal events of catheter procedure-related acute kidney injury after transcatheter aortic valve implantation. Am J Cardiol. 2020;133:89–97. https://doi.org/10.1016/j.amjcard.2020.07.041.

    Article  PubMed  Google Scholar 

  33. Julien HM, Stebbins A, Vemulapalli S, Nathan AS, Eneanya ND, Groeneveld P, et al. Incidence, predictors, and outcomes of acute kidney injury in patients undergoing transcatheter aortic valve replacement: insights from the Society of Thoracic Surgeons/American College of Cardiology national cardiovascular data registry-transcatheter valve therapy registry. Circ Cardiovasc Interv. 2021;14: e010032. https://doi.org/10.1161/CIRCINTERVENTIONS.120.010032.

    Article  PubMed  Google Scholar 

  34. Mehran R, Dangas GD, Weisbord SD. Contrast-associated acute kidney injury. N Engl J Med. 2019;380:2146–55. https://doi.org/10.1056/NEJMra1805256.

    Article  CAS  PubMed  Google Scholar 

  35. Eskandari M, Aldalati O, Byrne J, Dworakowski R, Wendler O, Alcock E, et al. Zero contrast transfemoral transcatheter aortic valve replacement using fluoroscopy-echocardiography fusion imaging. Am J Cardiol. 2016;117:1861–2. https://doi.org/10.1016/j.amjcard.2016.03.028.

    Article  PubMed  Google Scholar 

  36. Maffeo D, Bettari L, Latib A, Maiandi C, Villa E, Messina A, et al. Transfemoral transcatheter aortic valve replacement without contrast medium using the Medtronic CoreValve system: a single center experience. J Cardiovasc Surg (Torino). 2020;61:489–95. https://doi.org/10.23736/S0021-9509.20.11083-8.

    Article  Google Scholar 

  37. Blair JEA, Brummel K, Friedman JL, Atri P, Sweis RN, Russell H, et al. Inhospital and post-discharge changes in renal function after transcatheter aortic valve replacement. Am J Cardiol. 2016;117:633–69. https://doi.org/10.1016/j.amjcard.2015.11.047.

    Article  PubMed  Google Scholar 

  38. Jäckel M, Keller S, Prager EP, Staudacher DL, Schlett C, Zehender M, et al. The impact of transcatheter aortic valve implantation planning and procedure on acute and chronic renal failure. Cardiol J. 2021. https://doi.org/10.5603/CJ.a2021.0057.

    Article  PubMed  Google Scholar 

  39. Sabe MA, Claggett B, Burdmann EA, Desai AS, Ivanovich P, Kewalramani R, et al. Coronary artery disease is a predictor of progression to dialysis in patients with chronic kidney disease, type 2 diabetes mellitus, and anemia: an analysis of the trial to reduce cardiovascular events with Aranesp therapy (TREAT). J Am Heart Assoc. 2016;5: e002850. https://doi.org/10.1161/JAHA.115.002850.

    Article  PubMed  PubMed Central  Google Scholar 

  40. Bansal N, Katz R, Robinson-Cohen C, Odden MC, Dalrymple L, Shlipak MG, et al. Absolute rates of heart failure, coronary heart disease, and stroke in chronic kidney disease: an analysis of 3 community-based cohort studies. JAMA Cardiol. 2017;2:314–8. https://doi.org/10.1001/jamacardio.2016.4652.

    Article  PubMed  PubMed Central  Google Scholar 

  41. Kottgen A, Russell SD, Loehr LR, Crainiceanu CM, Rosamond WD, Chang PP, et al. Reduced kidney function as a risk factor for incident heart failure: the Atherosclerosis Risk in Communities (ARIC) study. J Am Soc Nephrol. 2007;18:1307–15. https://doi.org/10.1681/ASN.2006101159.

    Article  CAS  PubMed  Google Scholar 

  42. Goel SS, Agarwal S, Tuzcu EM, Ellis SG, Svensson LG, Zaman T, et al. Percutaneous coronary intervention in patients with severe aortic stenosis: implications for transcatheter aortic valve replacement. Circulation. 2012;125:1005–13. https://doi.org/10.1161/CIRCULATIONAHA.111.039180.

    Article  PubMed  Google Scholar 

  43. Faroux L, Campelo-Parada F, Munoz-Garcia E, Nombela-Franco L, Fischer Q, Donaint P, et al. Procedural characteristics and late outcomes of percutaneous coronary intervention in the workup pre-TAVR. JACC Cardiovasc Interv. 2020;13:2601–13. https://doi.org/10.1016/j.jcin.2020.07.009.

    Article  PubMed  Google Scholar 

  44. Hioki H, Watanabe Y, Kozuma K, Nara Y, Kawashima H, Kataoka A, et al. Pre-procedural dual antiplatelet therapy in patients undergoing transcatheter aortic valve implantation increases risk of bleeding. Heart. 2017;103:361–437. https://doi.org/10.1136/heartjnl-2016-309735.

    Article  PubMed  Google Scholar 

  45. Li SX, Patel NK, Flannery LD, Cigarroa RJ, Shaqdan AW, Erickson P, et al. Impact of bleeding after transcatheter aortic valve replacement in patients with chronic kidney disease. Catheter Cardiovasc Interv. 2021;97:E172–8. https://doi.org/10.1002/ccd.28989.

    Article  PubMed  Google Scholar 

  46. Patterson T, Clayton T, Dodd M, Khawaja Z, Morice MC, Wilson K, et al. ACTIVATION (Percutaneous Coronary intervention prior to transcatheter aortic valve implantation): a randomized clinical trial. JACC Cardiovasc Intv. 2021;14:1965–74. https://doi.org/10.1016/j.jcin.2021.06.041.

    Article  Google Scholar 

  47. Ochiai T, Yoon SH, Flint N, Sharma R, Chakravarty T, Kaewkes D, et al. Timing and outcomes of percutaneous coronary intervention in patients who underwent transcatheter aortic valve implantation. Am J Cardiol. 2020;125:1361–8. https://doi.org/10.1016/j.amjcard.2020.01.043.

    Article  PubMed  Google Scholar 

  48. Writing Committee Members, Otto CM, Nishimura RA, Bonow RO, Carabello BA, Erwin JP 3rd, et al. ACC/AHA guideline for the management of patients with valvular heart disease: executive summary: a report of the American College of Cardiology/American Heart Association Joint Committee on clinical practice guidelines. J Am Coll Cardiol. 2021;77:450–500.

    Google Scholar 

  49. Vahanian A, Beyersdorf F, Praz F, Milojevic M, Baldus S, Bauersachs J, et al. 2021 ESC/EACTS guidelines for the management of valvular heart disease. Eur Heart J. 2022;43:561–632.

    Article  Google Scholar 

  50. Stabile E, Pucciarelli A, Cota L, Sorropago G, Tesorio T, Salemme L, et al. SAT-TAVI (single antiplatelet therapy for TAVI) study: a pilot randomized study comparing double to single antiplatelet therapy for transcatheter aortic valve implantation. Int J Cardiol. 2014;174:624–7. https://doi.org/10.1016/j.ijcard.2014.04.170.

    Article  PubMed  Google Scholar 

  51. Rodés-Cabau J, Masson JB, Welsh RC, Garcia Del Blanco B, Pelletier M, Webb JG, et al. Aspirin versus aspirin plus clopidogrel as antithrombotic treatment following transcatheter aortic valve replacement with a balloon-expandable valve: the ARTE (aspirin versus aspirin + clopidogrel following transcatheter aortic valve implantation) randomized clinical trial. JACC Cardiovasc Interv. 2017;10:1357–65. https://doi.org/10.1016/j.jcin.2017.04.014.

    Article  PubMed  Google Scholar 

  52. Brouwer J, Nijenhuis VJ, Delewi R, Hermanides RS, Holvoet W, Dubois CLF, et al. Aspirin with or without clopidogrel after transcatheter aortic-valve implantation. N Engl J Med. 2020;383:1447–57.

    Article  CAS  Google Scholar 

  53. Nijenhuis VJ, Brouwer J, Delewi R, Hermanides RS, Holvoet W, Dubois CLF, et al. Anticoagulation with or without clopidogrel after transcatheter aortic-valve implantation. N Engl J Med. 2020;382:1696–707.

    Article  CAS  Google Scholar 

  54. Mentias A, Desai MY, Saad M, Horwitz PA, Rossen JD, Panaich S, et al. Management of aortic stenosis in patients with end-stage renal disease on hemodialysis. Circ Cardiovasc Interv. 2020;13: e009252. https://doi.org/10.1161/CIRCINTERVENTIONS.120.009252.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  55. Ogami T, Kurlansky P, Takayama H, Ning Y, Zimmermann E, Zhu RC, et al. Three-year survival of transcatheter versus surgical aortic valve replacement in dialysis. Catheter Cardiovasc Interv. 2022. https://doi.org/10.1002/ccd.30045.

    Article  PubMed  Google Scholar 

  56. Szerlip M, Zajarias A, Vemalapalli S, Brennan M, Dai D, Maniar H, et al. Transcatheter aortic valve replacement in patients with end-stage renal disease. J Am Coll Cardiol. 2019;73:2806–15. https://doi.org/10.1016/j.jacc.2019.03.496.

    Article  PubMed  Google Scholar 

  57. Kuno T, Takagi H, Ando T, Ueyama H, Fujisaki T, Kodaira M, et al. Short- and long-term outcomes in dialysis patients undergoing transcatheter aortic valve implantation: a systematic review and meta-analysis. Can J Cardiol. 2020;36:1754–63. https://doi.org/10.1016/j.cjca.2020.01.015.

    Article  PubMed  Google Scholar 

  58. Kawase Y, Taniguchi T, Morimoto T, Kadota K, Iwasaki K, Kuwayama A, et al. Severe aortic stenosis in dialysis patients. J Am Heart Assoc. 2017;6: e004961. https://doi.org/10.1161/JAHA.116.004961.

    Article  PubMed  PubMed Central  Google Scholar 

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Correspondence to Masanori Yamamoto.

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Dr. Yamamoto is a clinical proctor for Edwards Lifesciences and Medtronic. Dr. Adachi has nothing to disclose.

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Adachi, Y., Yamamoto, M. & the OCEAN-SHD family. Chronic kidney disease and transcatheter aortic valve implantation. Cardiovasc Interv and Ther 37, 458–464 (2022). https://doi.org/10.1007/s12928-022-00859-x

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