Background Acute kidney injury (AKI) is a common post-transcatheter aortic valve replacement (TAVR) complication associated with a poor prognosis. We sought to create a risk calculator using information that would be available during the work-up period.
Methods Data were obtained from a multicentre TAVR registry (n=1993) with cases from 1 January 2012 to 31 December 2015. We used logistic regression to create a risk calculator to predict AKI as defined by the Valve Academic Research Consortium Guidelines. We internally validated our risk calculator using bootstrapping, and evaluated model discrimination and calibration.
Results A simple risk score was derived with six variables, including New York Heart Association functional classification class 4, non-femoral access site, valve-in-valve procedure, haemoglobin, creatinine clearance and weight in kilograms. The score was able to predict the absolute risk of AKI from 1% to 72%. The model showed good discrimination with c-statistic 0.713, with good agreement between predicted and observed AKI rates across quintiles of risk.
Conclusions This is the first risk calculator to assess post-TAVR risk of AKI. We found that information known pre-procedurally can be used to predict AKI. This may allow for more informed decision-making as well as identifying high-risk patients.
- aortic stenosis
- aortic regurgitation
- acute kidney injury
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Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Patient consent Not required.
Ethics approval Sunnybrook Hospital, St Michael’s Hospital, Quebec Heart and Lung Institute, Tel Aviv Medical Centre, Hadassah Hebrew University Medical Centre and Sheba Medical Center.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement No additional data are available.
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