Renal Function–Based Contrast Threshold Predicts Kidney Injury in Transcatheter Aortic Valve Replacement

BackgroundAcute kidney injury (AKI) after contrast-guided interventions is associated with adverse outcomes, but the role of contrast in context renal function less well described for patients undergoing transcatheter aortic valve replacement (TAVR).MethodsPatients from Michigan TAVR registry between January 2016 and December 2019 were included. AKI was defined using Valve Academic Research Consortium 2 definitions. An integer cut point ratio volume (CV) to (estimated glomerular filtration rate [eGFR]) as a predictor calculated.ResultsOf 7112 cases, occurred 629 (8.8%) patients. Unadjusted mortality higher among (32.5% vs 9.0%, P ​< ​.0001). remained significantly risk multivariable adjustment (hazard = 4.50, ​.001). Procedural characteristics included CV/eGFR >2 (adjusted odds [aOR] 1.36, .003, 95% CI 1.10-1.67), >3 (aOR 1.38, ​= ​.009, 1.09-1.77), use general anesthesia 1.67, ​.0001, 1.38-2.03).ConclusionsCV administrated during robust tool predict AKI. an increased mortality. Incorporation thresholds >2× > 3× eGFR into procedural planning should be considered quality initiative.