The association between elevated preoperative pulse pressure and acute kidney injury after transcatheter aortic valve implantation

Abstract

Transcatheter aortic valve implantation (TAVI) can be complicated by acute kidney injury (AKI). AKI has been found to be independently associated with mortality, but the risk factors are unclear. The association between arterial stiffness and renal dysfunction is well known, but the association between TAVI and AKI requires investigation. We retrospectively investigated 74 patients undergoing TAVI under general anesthesia about risk factors of AKI after TAVI including peripheral pulse pressure as an index of arterial stiffness. AKI after TAVI occurred in 44.6% (33 patients), the length of stay in ICU and that in hospital after TAVI were both significantly longer in AKI patients than in non-AKI patients (P<0.001) and there was significant difference in 1 year mortality between them (P=0.015). In multivariable logistic regression analysis, the incidence of AKI was independently associated with transapical approach (OR: 13.1, 95%CI: 3.34-50.9, P<0.01) and peripheral pulse pressure (OR: 1.09, 95%CI: 1.04-1.13, P<0.001). Elevated pulse pressure can be a predictor of AKI after TAVI.