Long-term Effect of Transcatheter Aortic Valve Replacement on Renal Function

Background: Patients with severe aortic stenosis (AS) referred for transcatheter aortic valve replacement (TAVR) often have reduced renal function, which may be due to reduced cardiac output and renal hypoperfusion. Improved hemodynamics following TAVR may potentially result in improved renal function. Conversely, peri-procedural hypotension, particulate embolization to the kidneys and exposure to contrast media may lead to further decline in renal function following TAVR. We studied the long-term effect of TAVR on renal function.

Methods: Clinical, demographic and procedural data was documented in our prospective institutional TAVR registry. Renal function was studied at 3 time-points: baseline, 1-month and 6-months following the procedure. Patients treated with dialysis prior to TAVR were excluded from the study.

Results: 218 patients were included in the present analysis. Mean age was 81±7 years and 55% were female. Glomerular filtration rate (GFR) was 56±26, 57±30 and 54±30 ml/min at baseline, 1-month and 6-months respectively (p=0.85 for baseline vs. 1-month; p=0.39 for baseline vs. 6-months). In the subgroup of patients with baseline GFR≤44 ml/min (n=77), GFR was 35±7 and 35±10 ml/min at baseline and 6-months respectively (p=0.985). In the subgroup of patients with baseline GFR≥45 ml/min, GFR was 68±26 and 65±33 ml/min at baseline and at 6-months respectively (p=0.024)

Conclusions: TAVR resulted in no change in renal function in the present cohort. In the subgroup of patients with mildly reduced or normal renal function at baseline, TAVR was associated with improved renal function.