Acute kidney injury after MitraClip implantation in patients with severe mitral regurgitation
Introduction Percutaneous mitral valve repair (PMVR), such as MitraClip, is performed on high‐risk patients and involves hemodynamic alternations that may cause acute kidney injury (AKI). We aimed to evaluate the incidence of AKI, predictors for developing AKI and the correlation with mortality afte...
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| Veröffentlicht in: | Catheterization and cardiovascular interventions 2021-05, Vol.97 (6), p.E868-E874 |
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| creator | Tonchev, Ivaylo Heberman, Dan Peretz, Alona Medvedovsky, Anna Turyan Gotsman, Israel Rashi, Yonatan Poles, Lion Goland, Sorel Perlman, Gidon Y. Danenberg, Haim D. Beeri, Ronen Shuvy, Mony |
| description | Introduction
Percutaneous mitral valve repair (PMVR), such as MitraClip, is performed on high‐risk patients and involves hemodynamic alternations that may cause acute kidney injury (AKI). We aimed to evaluate the incidence of AKI, predictors for developing AKI and the correlation with mortality after MitraClip.
Methods
We performed a retrospective analysis of collected data from patients who underwent PMVR in two tertiary medical centers in Israel to identify factors associated with AKI.
Results
The study population included 163 patients. The median age was 77 years; 60.7% of patients were male. The median eGFR significantly decreased post‐procedure from 49 (35–72) to 47.8 (31–65.5) ml/min/1.73 m2 (p 5 mmHg, diuretic use, and re‐do procedures. Among the patients who developed AKI there was an improvement in kidney function during follow‐up, and creatinine levels significantly decreased from a peak mean creatinine of 179.5 (143–252) mmol/l to 136 (92–174) mmol/l (p |
| doi_str_mv | 10.1002/ccd.29250 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2438990938</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2438990938</sourcerecordid><originalsourceid>FETCH-LOGICAL-c2680-b1ccbb2ddaba0efceca91d15e3a2f0d02eef8909eab96cd6d94f545163f06c1b3</originalsourceid><addsrcrecordid>eNp10EtLxDAUBeAgiu-Ff0ACbnQxY5I2sVlKfYLiRsGNhDS51Yx9mbQO8-_N2NGF4OrexcfhcBA6oGRKCWGnxtgpk4yTNbRNOWOTMyae11c_lanYQjshzAghUjC5ibYSlgmenclt9HJuhh7wu7MNLLBrZoNfYF324PG9673OK9dhV3eVbnrdu7aJBnfxg6YPeO76NxzgEzzgeskr7OF18K9uxHtoo9RVgP3V3UVPV5eP-c3k7uH6Nj-_mxgmMjIpqDFFwazVhSZQGjBaUks5JJqVxBIGUGaSSNCFFMYKK9OSp5yKpCTC0CLZRcdjbufbjwFCr2oXDFSxNbRDUCxNMhkDkizSoz901g6-ie0U4yyVlIuMR3UyKuPbEDyUqvOu1n6hKFHLzVXcXH1vHu3hKnEoarC_8mfkCE5HMHcVLP5PUnl-MUZ-AeSGjRM</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2524915685</pqid></control><display><type>article</type><title>Acute kidney injury after MitraClip implantation in patients with severe mitral regurgitation</title><source>Wiley Online Library Journals Frontfile Complete</source><creator>Tonchev, Ivaylo ; Heberman, Dan ; Peretz, Alona ; Medvedovsky, Anna Turyan ; Gotsman, Israel ; Rashi, Yonatan ; Poles, Lion ; Goland, Sorel ; Perlman, Gidon Y. ; Danenberg, Haim D. ; Beeri, Ronen ; Shuvy, Mony</creator><creatorcontrib>Tonchev, Ivaylo ; Heberman, Dan ; Peretz, Alona ; Medvedovsky, Anna Turyan ; Gotsman, Israel ; Rashi, Yonatan ; Poles, Lion ; Goland, Sorel ; Perlman, Gidon Y. ; Danenberg, Haim D. ; Beeri, Ronen ; Shuvy, Mony</creatorcontrib><description>Introduction
Percutaneous mitral valve repair (PMVR), such as MitraClip, is performed on high‐risk patients and involves hemodynamic alternations that may cause acute kidney injury (AKI). We aimed to evaluate the incidence of AKI, predictors for developing AKI and the correlation with mortality after MitraClip.
Methods
We performed a retrospective analysis of collected data from patients who underwent PMVR in two tertiary medical centers in Israel to identify factors associated with AKI.
Results
The study population included 163 patients. The median age was 77 years; 60.7% of patients were male. The median eGFR significantly decreased post‐procedure from 49 (35–72) to 47.8 (31–65.5) ml/min/1.73 m2 (p < .001). Forty‐seven patients (29%) developed AKI. None of the patients who developed AKI required hemodialysis. Predictors of AKI included: baseline eGFR ≤30 ml/min/1.73 m2, severity of residual MR, TMPG>5 mmHg, diuretic use, and re‐do procedures. Among the patients who developed AKI there was an improvement in kidney function during follow‐up, and creatinine levels significantly decreased from a peak mean creatinine of 179.5 (143–252) mmol/l to 136 (92–174) mmol/l (p < .001). However, 19% (9 out of 47) of patients experienced partial recovery and their creatinine level, when compared to their baseline, remained elevated. One‐year survival showed a trend for increased mortality among patients who developed AKI (86.2% vs. 80.9%, p = .4), and patients who developed AKI that persisted had increased 1‐year mortality compared with patients that had recovered their kidney function (86.8% vs. 55.6%, p = .01).
Conclusion
The incidence of AKI after MitraClip is high. AKI is reversible in most patients; however, the persistence of kidney injury is associated with increased 1‐year mortality.</description><identifier>ISSN: 1522-1946</identifier><identifier>EISSN: 1522-726X</identifier><identifier>DOI: 10.1002/ccd.29250</identifier><identifier>PMID: 32865879</identifier><language>eng</language><publisher>Hoboken, USA: John Wiley & Sons, Inc</publisher><subject>acute kidney injury ; Creatinine ; Diuretics ; Epidermal growth factor receptors ; Hemodialysis ; Kidneys ; MitraClip ; mitral regurgitation ; Mitral valve ; Mortality ; Population studies ; Regurgitation</subject><ispartof>Catheterization and cardiovascular interventions, 2021-05, Vol.97 (6), p.E868-E874</ispartof><rights>2020 Wiley Periodicals LLC.</rights><rights>2021 Wiley Periodicals LLC.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c2680-b1ccbb2ddaba0efceca91d15e3a2f0d02eef8909eab96cd6d94f545163f06c1b3</citedby><cites>FETCH-LOGICAL-c2680-b1ccbb2ddaba0efceca91d15e3a2f0d02eef8909eab96cd6d94f545163f06c1b3</cites><orcidid>0000-0001-8313-3789 ; 0000-0002-4405-4698</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fccd.29250$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fccd.29250$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32865879$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Tonchev, Ivaylo</creatorcontrib><creatorcontrib>Heberman, Dan</creatorcontrib><creatorcontrib>Peretz, Alona</creatorcontrib><creatorcontrib>Medvedovsky, Anna Turyan</creatorcontrib><creatorcontrib>Gotsman, Israel</creatorcontrib><creatorcontrib>Rashi, Yonatan</creatorcontrib><creatorcontrib>Poles, Lion</creatorcontrib><creatorcontrib>Goland, Sorel</creatorcontrib><creatorcontrib>Perlman, Gidon Y.</creatorcontrib><creatorcontrib>Danenberg, Haim D.</creatorcontrib><creatorcontrib>Beeri, Ronen</creatorcontrib><creatorcontrib>Shuvy, Mony</creatorcontrib><title>Acute kidney injury after MitraClip implantation in patients with severe mitral regurgitation</title><title>Catheterization and cardiovascular interventions</title><addtitle>Catheter Cardiovasc Interv</addtitle><description>Introduction
Percutaneous mitral valve repair (PMVR), such as MitraClip, is performed on high‐risk patients and involves hemodynamic alternations that may cause acute kidney injury (AKI). We aimed to evaluate the incidence of AKI, predictors for developing AKI and the correlation with mortality after MitraClip.
Methods
We performed a retrospective analysis of collected data from patients who underwent PMVR in two tertiary medical centers in Israel to identify factors associated with AKI.
Results
The study population included 163 patients. The median age was 77 years; 60.7% of patients were male. The median eGFR significantly decreased post‐procedure from 49 (35–72) to 47.8 (31–65.5) ml/min/1.73 m2 (p < .001). Forty‐seven patients (29%) developed AKI. None of the patients who developed AKI required hemodialysis. Predictors of AKI included: baseline eGFR ≤30 ml/min/1.73 m2, severity of residual MR, TMPG>5 mmHg, diuretic use, and re‐do procedures. Among the patients who developed AKI there was an improvement in kidney function during follow‐up, and creatinine levels significantly decreased from a peak mean creatinine of 179.5 (143–252) mmol/l to 136 (92–174) mmol/l (p < .001). However, 19% (9 out of 47) of patients experienced partial recovery and their creatinine level, when compared to their baseline, remained elevated. One‐year survival showed a trend for increased mortality among patients who developed AKI (86.2% vs. 80.9%, p = .4), and patients who developed AKI that persisted had increased 1‐year mortality compared with patients that had recovered their kidney function (86.8% vs. 55.6%, p = .01).
Conclusion
The incidence of AKI after MitraClip is high. AKI is reversible in most patients; however, the persistence of kidney injury is associated with increased 1‐year mortality.</description><subject>acute kidney injury</subject><subject>Creatinine</subject><subject>Diuretics</subject><subject>Epidermal growth factor receptors</subject><subject>Hemodialysis</subject><subject>Kidneys</subject><subject>MitraClip</subject><subject>mitral regurgitation</subject><subject>Mitral valve</subject><subject>Mortality</subject><subject>Population studies</subject><subject>Regurgitation</subject><issn>1522-1946</issn><issn>1522-726X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNp10EtLxDAUBeAgiu-Ff0ACbnQxY5I2sVlKfYLiRsGNhDS51Yx9mbQO8-_N2NGF4OrexcfhcBA6oGRKCWGnxtgpk4yTNbRNOWOTMyae11c_lanYQjshzAghUjC5ibYSlgmenclt9HJuhh7wu7MNLLBrZoNfYF324PG9673OK9dhV3eVbnrdu7aJBnfxg6YPeO76NxzgEzzgeskr7OF18K9uxHtoo9RVgP3V3UVPV5eP-c3k7uH6Nj-_mxgmMjIpqDFFwazVhSZQGjBaUks5JJqVxBIGUGaSSNCFFMYKK9OSp5yKpCTC0CLZRcdjbufbjwFCr2oXDFSxNbRDUCxNMhkDkizSoz901g6-ie0U4yyVlIuMR3UyKuPbEDyUqvOu1n6hKFHLzVXcXH1vHu3hKnEoarC_8mfkCE5HMHcVLP5PUnl-MUZ-AeSGjRM</recordid><startdate>20210501</startdate><enddate>20210501</enddate><creator>Tonchev, Ivaylo</creator><creator>Heberman, Dan</creator><creator>Peretz, Alona</creator><creator>Medvedovsky, Anna Turyan</creator><creator>Gotsman, Israel</creator><creator>Rashi, Yonatan</creator><creator>Poles, Lion</creator><creator>Goland, Sorel</creator><creator>Perlman, Gidon Y.</creator><creator>Danenberg, Haim D.</creator><creator>Beeri, Ronen</creator><creator>Shuvy, Mony</creator><general>John Wiley & Sons, Inc</general><general>Wiley Subscription Services, Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7U9</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-8313-3789</orcidid><orcidid>https://orcid.org/0000-0002-4405-4698</orcidid></search><sort><creationdate>20210501</creationdate><title>Acute kidney injury after MitraClip implantation in patients with severe mitral regurgitation</title><author>Tonchev, Ivaylo ; Heberman, Dan ; Peretz, Alona ; Medvedovsky, Anna Turyan ; Gotsman, Israel ; Rashi, Yonatan ; Poles, Lion ; Goland, Sorel ; Perlman, Gidon Y. ; Danenberg, Haim D. ; Beeri, Ronen ; Shuvy, Mony</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c2680-b1ccbb2ddaba0efceca91d15e3a2f0d02eef8909eab96cd6d94f545163f06c1b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>acute kidney injury</topic><topic>Creatinine</topic><topic>Diuretics</topic><topic>Epidermal growth factor receptors</topic><topic>Hemodialysis</topic><topic>Kidneys</topic><topic>MitraClip</topic><topic>mitral regurgitation</topic><topic>Mitral valve</topic><topic>Mortality</topic><topic>Population studies</topic><topic>Regurgitation</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Tonchev, Ivaylo</creatorcontrib><creatorcontrib>Heberman, Dan</creatorcontrib><creatorcontrib>Peretz, Alona</creatorcontrib><creatorcontrib>Medvedovsky, Anna Turyan</creatorcontrib><creatorcontrib>Gotsman, Israel</creatorcontrib><creatorcontrib>Rashi, Yonatan</creatorcontrib><creatorcontrib>Poles, Lion</creatorcontrib><creatorcontrib>Goland, Sorel</creatorcontrib><creatorcontrib>Perlman, Gidon Y.</creatorcontrib><creatorcontrib>Danenberg, Haim D.</creatorcontrib><creatorcontrib>Beeri, Ronen</creatorcontrib><creatorcontrib>Shuvy, Mony</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Catheterization and cardiovascular interventions</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Tonchev, Ivaylo</au><au>Heberman, Dan</au><au>Peretz, Alona</au><au>Medvedovsky, Anna Turyan</au><au>Gotsman, Israel</au><au>Rashi, Yonatan</au><au>Poles, Lion</au><au>Goland, Sorel</au><au>Perlman, Gidon Y.</au><au>Danenberg, Haim D.</au><au>Beeri, Ronen</au><au>Shuvy, Mony</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Acute kidney injury after MitraClip implantation in patients with severe mitral regurgitation</atitle><jtitle>Catheterization and cardiovascular interventions</jtitle><addtitle>Catheter Cardiovasc Interv</addtitle><date>2021-05-01</date><risdate>2021</risdate><volume>97</volume><issue>6</issue><spage>E868</spage><epage>E874</epage><pages>E868-E874</pages><issn>1522-1946</issn><eissn>1522-726X</eissn><abstract>Introduction
Percutaneous mitral valve repair (PMVR), such as MitraClip, is performed on high‐risk patients and involves hemodynamic alternations that may cause acute kidney injury (AKI). We aimed to evaluate the incidence of AKI, predictors for developing AKI and the correlation with mortality after MitraClip.
Methods
We performed a retrospective analysis of collected data from patients who underwent PMVR in two tertiary medical centers in Israel to identify factors associated with AKI.
Results
The study population included 163 patients. The median age was 77 years; 60.7% of patients were male. The median eGFR significantly decreased post‐procedure from 49 (35–72) to 47.8 (31–65.5) ml/min/1.73 m2 (p < .001). Forty‐seven patients (29%) developed AKI. None of the patients who developed AKI required hemodialysis. Predictors of AKI included: baseline eGFR ≤30 ml/min/1.73 m2, severity of residual MR, TMPG>5 mmHg, diuretic use, and re‐do procedures. Among the patients who developed AKI there was an improvement in kidney function during follow‐up, and creatinine levels significantly decreased from a peak mean creatinine of 179.5 (143–252) mmol/l to 136 (92–174) mmol/l (p < .001). However, 19% (9 out of 47) of patients experienced partial recovery and their creatinine level, when compared to their baseline, remained elevated. One‐year survival showed a trend for increased mortality among patients who developed AKI (86.2% vs. 80.9%, p = .4), and patients who developed AKI that persisted had increased 1‐year mortality compared with patients that had recovered their kidney function (86.8% vs. 55.6%, p = .01).
Conclusion
The incidence of AKI after MitraClip is high. AKI is reversible in most patients; however, the persistence of kidney injury is associated with increased 1‐year mortality.</abstract><cop>Hoboken, USA</cop><pub>John Wiley & Sons, Inc</pub><pmid>32865879</pmid><doi>10.1002/ccd.29250</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0001-8313-3789</orcidid><orcidid>https://orcid.org/0000-0002-4405-4698</orcidid></addata></record> |
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| source | Wiley Online Library Journals Frontfile Complete |
| subjects | acute kidney injury Creatinine Diuretics Epidermal growth factor receptors Hemodialysis Kidneys MitraClip mitral regurgitation Mitral valve Mortality Population studies Regurgitation |
| title | Acute kidney injury after MitraClip implantation in patients with severe mitral regurgitation |
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