Strategies to Avoid TAVI-related Acute Kidney Injury

Author(s): Polydoros N. Kampaktsis , Dmitriy N. Feldman , Konstantinos Charitakis .

Journal Name: Current Pharmaceutical Design

Volume 22 , Issue 13 , 2016

Abstract:

Acute kidney injury (AKI) is relatively common in patients undergoing transcatheter aortic valve implantation (TAVI) and has been associated with increased mortality and worse outcomes. The administration of iodinated contrast media in an elderly population with increased rates of chronic kidney injury and heart failure, the risk of hemodynamic compromise and the use of large catheters intra-procedurally make patients undergoing TAVI particularly vulnerable to renal insults and AKI. Furthermore, these patients are commonly exposed to iodinated contrast media during diagnostic and possible interventional procedures pre-TAVI. While risk factors such as baseline comorbidities are non-modifiable, others such as administration of nephrotoxic medications, the type and amount of contrast medium and the catheters size can be avoided, modified and improved. In addition, numerous other interventions such as volume expansion and possibly medications can prevent contrast related kidney injury. In this review, we sought to focus on strategies aiming at reducing the incidence of TAVI-related AKI.

Keywords: Transcatheter aortic valve implantation, Acute kidney injury, Contrast induced nephropathy

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Article Details

VOLUME: 22
ISSUE: 13
Year: 2016
Page: [1950 - 1958]
Pages: 9
DOI: 10.2174/1381612822666151208120522
Price: $58

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