Association between mid‐term worsening renal function and mortality after transcatheter aortic valve replacement in patients with chronic kidney disease

Introduction Chronic kidney disease (CKD), acute kidney injury (AKI) and worsening renal function at 30 days after transcatheter aortic valve replacement (TAVR) portend poor outcomes. We sought to evaluate the association between worsening renal function at 3–6 months and mortality among patients with baseline renal dysfunction undergoing TAVR. Methods This is a retrospective study of patients with glomerular filtration rate (GFR) 1.5 times compared to baseline, absolute increase of ≥0.3 mg/dl, or initiation of dialysis. Results Of 683 patients reviewed, 176 were included in the analysis (median age 84 [IQR 79–88] years, 56% female). Of these, 27 (15.3%) had worsening renal function. AKI post‐TAVR (OR 2.9, 95% CI 1.1–7.4, p = .03) and transfusion of ≥4 units red blood cells (OR 8.4, 95% CI 1.2–59, p = .03) were independent predictors of worsening renal function. Worsening renal function increased risk for mortality (HR 2.2, 95% CI 1.17–4.27, p = .015) at a median follow‐up of 691 days. Those with improved/stable function with baseline GFR