Predictors and Long-Term Prognostic Significance of Acute Renal Function Change in Patients Who Underwent Surgical Aortic Valve Replacement

• Published in: Journal of clinical medicine Vol. 12; no. 15; p. 4952
• Main Authors: Leviner, Dror B, Erez, Ely, Lavi, Idit, Saliba, Walid, Sharoni, Erez
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 27-07-2023; MDPI
• Subjects: Acute renal failure; Cardiac arrhythmia; Clinical medicine; Complications and side effects; Creatinine; Demographics; Heart valve replacement; Kidney diseases; Liver diseases; Patient outcomes; Patients; Prognosis; Statistical analysis; Statistics; Surgery; Israel; aortic valve replacement; renal function
• ISSN: 2077-0383; 2077-0383
• DOI: 10.3390/jcm12154952

There are few reports on short-term changes in renal function after surgical aortic valve replacement, and data are scarce regarding its impact on long-term outcomes. This is a retrospective study of patients who underwent isolated aortic valve replacement between 2009 and 2020 in four medical centers. Patients with end-stage renal disease were excluded. Renal function was assessed based on short-term changes. Multivariable regression models were used to identify predictors of improvement/deterioration. Cox proportional hazard models were used to assess survival trends. The study included 2402 patients, with a mean age of 69.3 years and a mean eGFR of 82.3 mL/min/1.73 m
. Short-term improvement rates were highest in stage 4 (24.4%) and stage 3 (16.8%) patients. Deterioration rates were highest in stage 1 (38.1%) and stage 2 (34.8%) patients. Deterioration in the chronic kidney disease stage was associated with a higher ten-year mortality (
< 0.001, HR 1.46); an improved stage trended toward improved survival (
= 0.14, HR 0.722). Patients with stage 3 and 4 kidney disease tended to remain stable or improve in the short term after aortic valve replacement while patients at stages 1 and 2 were at increased risk of deteriorating.