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经导管主动脉瓣植入术患者急性肾损伤的相关因素:一项系统评价和荟萃分析

Factors Associated With Acute Kidney Injury in Patients Undergoing Transcatheter Aortic Valve Implantation: A Systematic Review and Meta-Analysis.

作者信息

Benaicha Karima, Aldroubi Basel, Yousuf Paras, Nath Rabinder, Saveeta Fnu, Kanwal Fnu, Fatima Tehreem, Hirani Shamsha

机构信息

Internal Medicine, University Hospital Isaad Hassani Beni Messous, Algiers, DZA.

Medical College, Tishreen University, Latakia, SYR.

出版信息

Cureus. 2023 Sep 12;15(9):e45131. doi: 10.7759/cureus.45131. eCollection 2023 Sep.

Abstract

The aim of this meta-analysis is to assess the effect of different independent predictors on acute kidney injury (AKI) after transcatheter aortic valve implantation (TAVI). This meta-analysis adhered to the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). A comprehensive database search was conducted using PubMed, Web of Science, and Scopus for the period from January 1, 2015, to August 15, 2023. The following key terms were employed: "transcatheter aortic valve implantation" OR "transcatheter aortic valve replacement" AND "acute kidney injury" OR "acute renal failure." Our search was limited to studies published exclusively in the English language. The statistical analysis was conducted using RevMan version 5.4.1 (The Cochrane Collaboration). Estimates were presented as odds ratio (OR) with 95% confidence interval (CI) for categorical variables, while continuous variables were reported as mean difference (MD) with 95% CI. A total of 19 studies met the selection criteria and were included in the meta-analysis. The pooled incidence of AKI was reported as 20% (95% CI: 18-20%). Factors significantly associated with post-TAVI AKI encompass hypertension, chronic kidney disease (CKD), low estimated glomerular filtration rate (eGFR), high baseline creatinine levels, peripheral vascular disease (PVD), Society of Thoracic Surgeons (STS) score, European System for Cardiac Operative Risk Evaluation (EUROscore) II, and the transfemoral surgical approach.

摘要

本荟萃分析的目的是评估经导管主动脉瓣植入术(TAVI)后不同独立预测因素对急性肾损伤(AKI)的影响。本荟萃分析遵循系统评价和荟萃分析的首选报告项目(PRISMA)指南。使用PubMed、Web of Science和Scopus对2015年1月1日至2023年8月15日期间的文献进行了全面的数据库检索。使用了以下关键词:“经导管主动脉瓣植入术”或“经导管主动脉瓣置换术”以及“急性肾损伤”或“急性肾衰竭”。检索仅限于仅以英文发表的研究。使用RevMan 5.4.1版(Cochrane协作网)进行统计分析。分类变量的估计值以比值比(OR)和95%置信区间(CI)表示,连续变量则报告为平均差(MD)和95%CI。共有19项研究符合入选标准并纳入荟萃分析。AKI的合并发生率报告为20%(95%CI:18-20%)。与TAVI术后AKI显著相关的因素包括高血压、慢性肾脏病(CKD)、低估计肾小球滤过率(eGFR)、高基线肌酐水平、外周血管疾病(PVD)、胸外科医师协会(STS)评分、欧洲心脏手术风险评估系统(EUROscore)II以及经股动脉手术入路。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ca4f/10569799/6cb9436a9f7c/cureus-0015-00000045131-i01.jpg

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