Cardiac Intensive Therapy Clinic, Institute of Cardiology, Warsaw, Poland,
Interventional Cardiology and Angiology Clinic, Institute of Cardiology, Warsaw, Poland.
Clin Interv Aging. 2019 Jan 21;14:195-201. doi: 10.2147/CIA.S149916. eCollection 2019.
Aortic stenosis is the most common cause of valve replacement in Europe and North America with prevalence increasing with age. Transcatheter valve replacement (TAVR) represents an alternative for surgical valve replacement of severely stenotic valves. Despite lower risk of acute kidney injury compared to that associated with surgery, this complication remains prevalent in patients undergoing TAVR. There is a paucity of data confirming the relation of acute kidney injury with high morbidity and mortality, especially when superimposed on chronic kidney disease, which is a frequent comorbidity in the elderly with severe aortic stenosis. As there is no consensus on the prevention of acute kidney injury in patients undergoing TAVR, identification and limitation of risk factors are crucial. In this review, we aim to discuss the key aspects of acute kidney injury diagnosis, risk assessment, and outcomes in TAVR patients, and to point out gaps in current knowledge.
主动脉瓣狭窄是欧洲和北美的最常见的瓣膜置换原因，其患病率随年龄增长而增加。经导管瓣膜置换术（TAVR）是严重狭窄瓣膜手术置换的一种替代方法。尽管与手术相关的急性肾损伤风险较低，但这种并发症在接受 TAVR 的患者中仍然很普遍。目前缺乏数据证实急性肾损伤与高发病率和死亡率之间的关系，尤其是在慢性肾脏病的基础上发生时，这在老年严重主动脉瓣狭窄患者中是一种常见的合并症。由于 TAVR 患者中急性肾损伤的预防尚未达成共识，因此确定和限制风险因素至关重要。在这篇综述中，我们旨在讨论 TAVR 患者急性肾损伤诊断、风险评估和结果的关键方面，并指出当前知识的空白。
