Incidence, predictors, and relevance of acute kidney injury in patients undergoing left atrial appendage closure with Amplatzer occluders: a multicentre observational study
| Autor: | Bernhard Meier, Marco Valglimigli, Stephan Windecker, Fabian Nietlispach, Baravan Al-Kassou, Alexander Sedaghat, Georg Nickenig, Steffen Gloekler, Vivian Vij, Samuel R Streit, Dominik Nelles, Caroline Kleinecke, Jan W. Schrickel |
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| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty Cardiac Catheterization Time Factors Renal function Contrast Media 610 Medicine & health 030204 cardiovascular system & hematology urologic and male genital diseases Risk Assessment Severity of Illness Index 03 medical and health sciences 0302 clinical medicine Left atrial Risk Factors Internal medicine Germany Atrial Fibrillation medicine Humans In patient Atrial Appendage 030212 general & internal medicine Aged Retrospective Studies Aged 80 and over business.industry urogenital system Incidence (epidemiology) Incidence Acute kidney injury General Medicine Acute Kidney Injury medicine.disease female genital diseases and pregnancy complications Increased risk Treatment Outcome Cardiology Observational study Female Cardiology and Cardiovascular Medicine Complication business Switzerland |
| Zdroj: | Sedaghat, Alexander; Vij, Vivian; Streit, Samuel R; Schrickel, Jan Wilko; Al-Kassou, Baravan; Nelles, Dominik; Kleinecke, Caroline; Windecker, Stephan; Meier, Bernhard; Valglimigli, Marco; Nietlispach, Fabian; Nickenig, Georg; Gloekler, Steffen (2020). Incidence, predictors, and relevance of acute kidney injury in patients undergoing left atrial appendage closure with Amplatzer occluders: a multicentre observational study. Clinical research in cardiology, 109(4), pp. 444-453. Springer-Verlag 10.1007/s00392-019-01524-9 |
| DOI: | 10.1007/s00392-019-01524-9 |
| Popis: | AIMS Acute kidney injury (AKI) remains a frequent complication after cardiac interventions, such as left atrial appendage closure (LAAC), yet limited data are available on the incidence and clinical implication of AKI in this setting. We sought to assess incidence, predictors and relevance of AKI after LAAC. METHODS AND RESULTS We retrospectively analyzed 95 LAAC patients in three European centers. AKI was defined according to the Acute Kidney Injury Network (AKIN) classification. The incidence of AKI was 13.7% with mild AKI in 92.3% and AKI stage > II in 7.7%. Total contrast volume was not linked to the occurrence of AKI (AKI: 127 ± 83 vs. no AKI: 109 ± 92 ml, p = 0.41), however increasing contrast volume (CV) to glomerular filtration rate (GFR) ratio (CV/GFR ratio) was associated with an increased risk of AKI (OR, per unit increase: 1.24, 95% CI 0.97-1.58, p = 0.08). ROC-analysis revealed a moderate predictive value of CV/GFR ratio for the prediction of AKI (AUC: 0.67, 95% CI 0.50-0.84, p = 0.05). Furthermore, AKI was associated with significantly increased mortality 6 months and 1 year after LAAC. No significant difference in the incidence of AKI was observed between patients with mere fluoroscopic and additional echocardiographic guidance (16.3% vs. 11.5%, p = 0.56). CONCLUSION Whereas mild AKI is common in patients after LAAC, severe AKI is rare. AKI after LAAC is associated with poor baseline renal function, increased doses of contrast (CV/GFR ratio) and impaired outcome. Future studies will be needed to elaborate the benefit of reducing or avoiding contrast volume regarding this endpoint. |
| Databáze: | OpenAIRE |
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