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Introduction Transcatheter aortic valve replacement (TAVR) has been established as a standard of care for patients with severe aortic stenosis. We aim to study the predictors of acute kidney injury (AKI) after TAVR from a contemporary analysis using the National Inpatient Sample (NIS) database. Methods We performed a national analysis using the NIS database to evaluate predictors of acute kidney injury (AKI) after TAVR. Our study period was from 2015 to 2018, and we identified TAVR patients in all procedure fields. Patients aged less than 18 years were excluded from the study. Results We report data of 173,760 TAVR patients, of which 20,045 (11.5%) had AKI and 153,715 (88.4%) did not. There were three principal findings of our study. First, mortality was higher in patients with AKI compared to patients who did not have AKI (8% vs. 0.8%; p<0.01). Second, patients with chronic kidney disease, weight loss, liver disease, congestive heart failure, cerebrovascular disease, chronic obstructive pulmonary disease, metastatic cancer, and peripheral vascular disease had higher adjusted odds of AKI. Third, length of stay and cost of stay were significantly higher in patients who had AKI during the index admission. Conclusion Patients with AKI had higher in-hospital mortality. We also report that at baseline, chronic kidney disease, weight loss, liver disease, congestive heart failure, cerebrovascular disease, chronic obstructive pulmonary disease, metastatic cancer, and peripheral vascular disease were important predictors of AKI in patients after TAVR. Length of stay and cost of stay were higher with AKI, which result in higher burden on the health care system due to increased resource utilization.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8214866 | PMC |
http://dx.doi.org/10.7759/cureus.15154 | DOI Listing |
Liver Int
January 2025
Division of Gastroenterology-Hepatology, Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA.
Introduction: Racial/ethnic disparities have been previously reported in renal and hepatic disease care; however, acute kidney injury (AKI) in the setting of cirrhosis (hepatorenal syndrome [HRS]-AKI) despite its complexity requiring a multidisciplinary approach, remains understudied.
Methods: To identify unique associations of clinical and sociodemographic factors with mortality and length of stay (LOS) among patients hospitalised with HRS-AKI, hierarchical regression analysis was conducted, along with a mediation analysis to estimate how race-related differences in in-hospital mortality were influenced by payer type, area household income, and clinical severity.
Results: Black patients demonstrated a significantly higher odds of in-hospital mortality, compared to their white counterparts, adjusting for (1) sex and age, (2) sex, age, payer type, and area household income and (3) sex, age, and clinical severity [OR 1.
Front Med (Lausanne)
December 2024
Department of Nephrology, Peking University Third Hospital, Beijing, China.
Background: Gabapentinoids, such as gabapentin and pregabalin, are opioid substitutes commonly included in perioperative multimodal analgesia regimens. We investigated whether the initiation of gabapentin and pregabalin during the perioperative period have varying effects on the adverse renal outcomes.
Methods: This study included adult participants who received surgery in the INSPIRE database.
Pan Afr Med J
December 2024
Department of Surgery, Faculty of Medicine, Hasanuddin University, Hasanuddin University Hospital, Makassar, Indonesia.
Acute heart failure is associated with high hospitalization and mortality rates. A strong, independent risk factor for mortality in patients with heart failure is acute kidney injury, and the condition caused by this connection between disturbances in heart function and proper kidney functioning is cardiorenal syndrome (CRS). This case report discusses the role of continuous renal replacement therapy (CRRT) in the management of a CRS case with septic shock due to pneumonia.
View Article and Find Full Text PDFCureus
November 2024
Nephrology, Kanazawa Medical University, Kahoku, JPN.
Legionnaires' disease is a bacterial infection caused by , such as . It mainly causes severe pneumonia, with symptoms such as fever, cough, and shortness of breath. In rare cases, it can cause acute kidney disease and also occasionally become severe enough to require replacement therapy.
View Article and Find Full Text PDFCureus
November 2024
Internal Medicine, Robert Wood Johnson (RWJ) Barnabas Health, Long Branch, USA.
Background: Septic shock is defined as sepsis with hypotension requiring vasopressors to maintain a mean arterial pressure above 65 mmHg and having a serum lactate level of more than 2 mmol/L despite adequate volume resuscitation as per the Sepsis-3 criteria. Continuous renal replacement therapy (CRRT) is commonly utilized in septic shock patients for the treatment of acute kidney injury as well as for modulating immune response and maintaining hemodynamic stability.
Methods: We looked at the National Inpatient Sample database in 2019.
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