Acute Kidney Injury With the RenalGuard System in Patients Undergoing Transcatheter Aortic Valve Replacement
| Autor: | Marco Barbanti, Denise Todaro, Davide Capodanno, Alessio Di Landro, Gerlando Pilato, Guilherme F. Attizzani, Piera Capranzano, Sebastiano Immè, Corrado Tamburino, Giuliano Costa, Yohei Ohno, Giuliana Giannetto, Andrea Picci, Daniela Giannazzo, Carmelo Sgroi, Simona Gulino, Claudia Tamburino, Rita Sicuso, Wanda Deste, Martina Patanè, Emanuela Di Simone, Carmelo Grasso |
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| Rok vydání: | 2015 |
| Předmět: |
Aortic valve
medicine.medical_specialty business.industry medicine.medical_treatment Acute kidney injury medicine.disease Surgery Stenosis medicine.anatomical_structure Valve replacement Aortic valve stenosis Heart failure medicine Cardiology and Cardiovascular Medicine business Prospective cohort study Dialysis |
| Zdroj: | JACC: Cardiovascular Interventions. 8:1595-1604 |
| ISSN: | 1936-8798 |
| Popis: | Objectives The purpose of this study was to investigate the effect of the RenalGuard System (PLC Medical Systems, Milford, Massachusetts) on prevention of acute kidney injury (AKI) in patients undergoing transcatheter aortic valve replacement (TAVR). Background TAVR is associated with varying degrees of post-procedural AKI. The RenalGuard System is a dedicated device designed for contrast-induced AKI prevention. Whether this device is also effective in patients with severe aortic stenosis undergoing TAVR is unexplored. Methods The present is an investigator-driven, single-center, prospective, open-label, registry-based randomized study that used the TAVR institutional registry of the Ferrarotto Hospital in Catania, Italy, as the platform for randomization, data collection, and follow-up assessment. A total of 112 consecutive patients undergoing TAVR were randomly assigned to hydration with normal saline solution controlled by the RenalGuard system and furosemide (RenalGuard group) or normal saline solution (control group). The primary endpoint was the incidence of Valve Academic Research Consortium–defined AKI in the first 72 h after the procedure. Results The AKI rate was lower in the RenalGuard group than in the control group (n = 3 [5.4%] vs. n =14 [25.0%], respectively, p = 0.014). The majority of patients (5.4% vs. 23.2%) developed a mild AKI (stage 1); severe damage (stage 3) occurred only in 1 patient in the control group (0.0% vs. 1.8%). No case of in-hospital renal failure requiring dialysis was reported. No significant differences in terms of mortality, cerebrovascular events, bleeding, and hospitalization for heart failure were noted in both groups at 30 days. Conclusions Furosemide-induced diuresis with matched isotonic intravenous hydration using the RenalGuard system is an effective therapeutic tool to reduce the occurrence of AKI in patients undergoing TAVR. |
| Databáze: | OpenAIRE |
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