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  3. Incidence, predictors, and relevance of acute kidney injury in patients undergoing left atrial appendage closure with Amplatzer occluders: a multicentre observational study.
 

Incidence, predictors, and relevance of acute kidney injury in patients undergoing left atrial appendage closure with Amplatzer occluders: a multicentre observational study.

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BORIS DOI
10.7892/boris.139131
Date of Publication
April 2020
Publication Type
Article
Division/Institute

Universitätsklinik fü...

Author
Sedaghat, Alexander
Vij, Vivian
Streit, Samuel R
Schrickel, Jan Wilko
Al-Kassou, Baravan
Nelles, Dominik
Kleinecke, Caroline
Windecker, Stephan
Universitätsklinik für Kardiologie
Meier, Bernhard
Valgimigli, Marco
Universitätsklinik für Kardiologie
Nietlispach, Fabian
Nickenig, Georg
Gloekler, Steffen
Subject(s)

600 - Technology::610...

Series
Clinical research in cardiology
ISSN or ISBN (if monograph)
1861-0684
Publisher
Springer-Verlag
Language
English
Publisher DOI
10.1007/s00392-019-01524-9
PubMed ID
31278520
Uncontrolled Keywords

Acute kidney injury C...

Description
AIMS

Acute kidney injury (AKI) remains a frequent complication after cardiac interventions, such as left atrial appendage closure (LAAC), yet limited data are available on the incidence and clinical implication of AKI in this setting. We sought to assess incidence, predictors and relevance of AKI after LAAC.

METHODS AND RESULTS

We retrospectively analyzed 95 LAAC patients in three European centers. AKI was defined according to the Acute Kidney Injury Network (AKIN) classification. The incidence of AKI was 13.7% with mild AKI in 92.3% and AKI stage > II in 7.7%. Total contrast volume was not linked to the occurrence of AKI (AKI: 127 ± 83 vs. no AKI: 109 ± 92 ml, p = 0.41), however increasing contrast volume (CV) to glomerular filtration rate (GFR) ratio (CV/GFR ratio) was associated with an increased risk of AKI (OR, per unit increase: 1.24, 95% CI 0.97-1.58, p = 0.08). ROC-analysis revealed a moderate predictive value of CV/GFR ratio for the prediction of AKI (AUC: 0.67, 95% CI 0.50-0.84, p = 0.05). Furthermore, AKI was associated with significantly increased mortality 6 months and 1 year after LAAC. No significant difference in the incidence of AKI was observed between patients with mere fluoroscopic and additional echocardiographic guidance (16.3% vs. 11.5%, p = 0.56).

CONCLUSION

Whereas mild AKI is common in patients after LAAC, severe AKI is rare. AKI after LAAC is associated with poor baseline renal function, increased doses of contrast (CV/GFR ratio) and impaired outcome. Future studies will be needed to elaborate the benefit of reducing or avoiding contrast volume regarding this endpoint.
Handle
https://boris-portal.unibe.ch/handle/20.500.12422/186189
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