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首页> 外文期刊>The American Journal of Cardiology >Acute Kidney Recovery in Patients Who Underwent Transcatheter Versus Surgical Aortic Valve Replacement (from the Northern New England Cardiovascular Disease Study Group)
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Acute Kidney Recovery in Patients Who Underwent Transcatheter Versus Surgical Aortic Valve Replacement (from the Northern New England Cardiovascular Disease Study Group)

机译：接受经截面与手术主动脉瓣置换的患者急性肾脏复苏（来自新英格兰北部心血管疾病研究组）

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Acute kidney recovery (AKR) is a recently described phenomenon observed after transcatheter aortic valve replacement (TAVR) and is more frequent than acute kidney injury (AM). To determine the incidence and predictors of AKR between surgical aortic valve replacement (SAVR) and TAVR, we examined patients with chronic kidney disease and severe aortic stenosis who underwent SAVR or TAVR procedure between 2007 and 2017; excluding age 90, dialysis, endocarditis, non-aortic valve stenosis, or patients died within 48-hours post-procedure. AKR was defined as an increase of estimated glomerular filtration rate (eGFR) >25% and AM as decrease in eGFR >25% at discharge. Stroke, mortality, major bleeding, transfusion, and length of stay were examined. Multivariate logistic regression analysis was used to examine predictors of AKR. There were 750 transcatheter and 1,062 surgical patients and 319 pairs after propensity matching. AKR was observed in 26% TAVR versus 23.2% SAVR, p = 0.062. Highest recovery was in patients with eGFR <30 for both TAVR (33.7%) and SAVR (34.5 %) patients. Independent predictors of AKR were ejection fraction <50% (odds ratio [OR] 1.66, 95% confidence interval [CI] 1.02 to 2.71, p = 0.042), female gender (OR 1.66, 95% CI 1.1 to 2.5, p = 0.015), and obesity (OR 1.5, 95% CI 1.04-2.3, p = 0.032). Diabetes was a negative predictor of AKR (OR 0.55, 95% CI 0.36 to 0.84, p = 0.005). AKR was associated with improved secondary clinical outcomes compared with AM. In conclusion, AKR is a generalizable phenomenon occurring frequently and similarly among transcatheter or surgical aortic valve patients. Diabetes is a negative predictor of AKR, possibly indicative of less reversible kidney disease. (C) 2019 Elsevier Inc. All rights reserved.
机译：急性肾脏恢复（AKR）是经截觉管主动脉瓣膜置换（TAVR）后观察到的最近描述的现象，并且比急性肾损伤更频繁，更频繁。为了确定手术主动脉瓣膜置换术（SAVR）和TAVR之间Akr的发病率和预测，我们检查了慢性肾病和严重主动脉狭窄的患者，在2007年至2017年期间进行了遗址或TAVR程序;不包括90岁，透析，心内膜炎，非主动脉瓣狭窄或患者在过程后48小时内死亡。 Akr被定义为估计的肾小球过滤速率（EGFR）> 25％的增加，并且在放电时EGFR> 25％的降低。检查中风，死亡率，重大出血，输血和逗留时间。多变量逻辑回归分析用于检查AKR的预测因子。在倾向匹配后，有750个经截管和1,062名手术患者和319对。观察到26％Tavr与23.2％Savr，P = 0.062。患有最高恢复的EGFR <30患者，适用于TAVR（33.7％）和SAVR（34.5％）患者。 AKR的独立预测因子是喷射分数<50％（差距[或] 1.66,95％置信区间[CI] 1.02至2.71，P = 0.042），雌性性别（或1.66,95％CI 1.1至2.5，P = 0.015 ）和肥胖（或1.5,95％CI 1.04-2.3，P = 0.032）。糖尿病是AKR（或0.55,95％CI 0.36至0.84，P = 0.005）的负预测器。与AM相比，AKR与改善的继发性临床结果有关。总之，AKR是经经导管或外科主动脉瓣膜患者经常且同样发生的可推广现象。糖尿病是AKR的阴性预测因子，可能指示不可逆转的肾脏疾病。 （c）2019 Elsevier Inc.保留所有权利。

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