Cheungpasitporn Wisit, Thongprayoon Charat, Kashani Kianoush
Division of Nephrology and Hypertension, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA.
Department of Internal Medicine, Bassett Medical Center, Cooperstown, NY, USA.
J Renal Inj Prev. 2016 Jan 18;5(1):1-7. doi: 10.15171/jrip.2016.01. eCollection 2016.
Transcatheter aortic valve replacement (TAVR) has now emerged as a viable treatment option for high-risk patients with severe aortic stenosis (AS) who are not suitable candidates for surgical aortic valve replacement (SAVR). Despite encouraging published outcomes, acute kidney injury (AKI) is common and lowers the survival of patients after TAVR. The pathogenesis of AKI after TAVR is multifactorial including TAVR specific factors such as the use of contrast agents, hypotension during rapid pacing, and embolization; preventive measures may include pre-procedural hydration, limitation of contrast dye exposure, and avoidance of intraprocedural hypotension. In recent years, the number of TAVR performed worldwide has been increasing, as well as published data on renal perspectives of TAVR including AKI, chronic kidney disease, end-stage kidney disease, and kidney transplantation. This review aims to present the current literature on the nephrology aspects of TAVR, ultimately to improve the patients' quality of care and outcomes.
经导管主动脉瓣置换术（TAVR）现已成为严重主动脉瓣狭窄（AS）高危患者的一种可行治疗选择，这些患者不适合接受外科主动脉瓣置换术（SAVR）。尽管已发表的结果令人鼓舞，但急性肾损伤（AKI）很常见，并且会降低TAVR术后患者的生存率。TAVR术后AKI的发病机制是多因素的，包括TAVR特有的因素，如使用造影剂、快速起搏期间的低血压和栓塞；预防措施可能包括术前水化、限制造影剂暴露以及避免术中低血压。近年来，全球范围内进行的TAVR数量不断增加，同时也有关于TAVR肾脏方面的已发表数据，包括AKI、慢性肾脏病、终末期肾病和肾移植。本综述旨在介绍当前关于TAVR肾脏学方面的文献，最终改善患者的护理质量和治疗结果。
