Association of CKD with Outcomes Among Patients Undergoing Transcatheter Aortic Valve Implantation
Despitethe multiple depicted associations of CKD with reduced cardiovascular and overall prognoses, the association of CKD with outcome of patients undergoing transcatheter aortic valve implantation has still not been well described. Data from all hospitalized patients who underwent transcatheter ao...
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| Veröffentlicht in: | Clinical journal of the American Society of Nephrology 2017-05, Vol.12 (5), p.718-726 |
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| creator | Lüders, Florian Kaier, Klaus Kaleschke, Gerrit Gebauer, Katrin Meyborg, Matthias Malyar, Nasser M Freisinger, Eva Baumgartner, Helmut Reinecke, Holger Reinöhl, Jochen |
| description | Despitethe multiple depicted associations of CKD with reduced cardiovascular and overall prognoses, the association of CKD with outcome of patients undergoing transcatheter aortic valve implantation has still not been well described.
Data from all hospitalized patients who underwent transcatheter aortic valve implantation procedures between January 1, 2010 and December 31, 2013 in Germany were evaluated regarding influence of CKD, even in the earlier stages, on morbidity, in-hospital outcomes, and costs.
A total of 28,716 patients were treated with transcatheter aortic valve implantation. A total of 11,189 (39.0%) suffered from CKD. Patients with CKD were predominantly women; had higher rates of comorbidities, such as coronary artery disease, heart failure at New York Heart Association 3/4, peripheral artery disease, and diabetes; and had a 1.3-fold higher estimated logistic European System for Cardiac Operative Risk Evaluation value. In-hospital mortality was independently associated with CKD stage ≥3 (up to odds ratio, 1.71; 95% confidence interval, 1.35 to 2.17; |
| doi_str_mv | 10.2215/CJN.10471016 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_5477218</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1877526491</sourcerecordid><originalsourceid>FETCH-LOGICAL-c384t-89abdf8fcb2d061b3700ca83bfe476774e8b18aedfba5210cbe30fbd5c8477c83</originalsourceid><addsrcrecordid>eNpVkU1PAyEQhonRaK3ePBuOHlwFFhZ6MWnqV7WxHtR4I8CyLWZ3qUA1_nvXjzZ6msnMM-_M5AXgAKMTQjA7Hd3cnWBEOUa42AA9zBjLBog9b65zinfAbowvCFGaE7YNdoggYoAK3gN6GKM3TiXnW-grOLo9h-8uzeF0mYxvbITDxrczeN8Rtk0RPralDTPvutpDUG00Ks1tsgEOfUjOwCdVv1k4bha1atO37B7YqlQd7f5v7IPHy4uH0XU2mV6NR8NJZnJBUyYGSpeVqIwmJSqwzjlCRolcV5bygnNqhcZC2bLSihGMjLY5qnTJjKCcG5H3wdmP7mKpG1ua7tygarkIrlHhQ3rl5P9O6-Zy5t8k6-YJ_hI4-hUI_nVpY5KNi8bW3SfWL6PEgnNGCjrAHXr8g5rgYwy2Wq_BSH7ZIjtb5MqWDj_8e9oaXvmQfwKgeosf</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1877526491</pqid></control><display><type>article</type><title>Association of CKD with Outcomes Among Patients Undergoing Transcatheter Aortic Valve Implantation</title><source>MEDLINE</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>PubMed Central</source><source>Alma/SFX Local Collection</source><creator>Lüders, Florian ; Kaier, Klaus ; Kaleschke, Gerrit ; Gebauer, Katrin ; Meyborg, Matthias ; Malyar, Nasser M ; Freisinger, Eva ; Baumgartner, Helmut ; Reinecke, Holger ; Reinöhl, Jochen</creator><creatorcontrib>Lüders, Florian ; Kaier, Klaus ; Kaleschke, Gerrit ; Gebauer, Katrin ; Meyborg, Matthias ; Malyar, Nasser M ; Freisinger, Eva ; Baumgartner, Helmut ; Reinecke, Holger ; Reinöhl, Jochen</creatorcontrib><description>Despitethe multiple depicted associations of CKD with reduced cardiovascular and overall prognoses, the association of CKD with outcome of patients undergoing transcatheter aortic valve implantation has still not been well described.
Data from all hospitalized patients who underwent transcatheter aortic valve implantation procedures between January 1, 2010 and December 31, 2013 in Germany were evaluated regarding influence of CKD, even in the earlier stages, on morbidity, in-hospital outcomes, and costs.
A total of 28,716 patients were treated with transcatheter aortic valve implantation. A total of 11,189 (39.0%) suffered from CKD. Patients with CKD were predominantly women; had higher rates of comorbidities, such as coronary artery disease, heart failure at New York Heart Association 3/4, peripheral artery disease, and diabetes; and had a 1.3-fold higher estimated logistic European System for Cardiac Operative Risk Evaluation value. In-hospital mortality was independently associated with CKD stage ≥3 (up to odds ratio, 1.71; 95% confidence interval, 1.35 to 2.17;
<0.05), bleeding was independently associated with CKD stage ≥4 (up to odds ratio, 1.82; 95% confidence interval, 1.47 to 2.24;
<0.001), and AKI was independently associated with CKD stages 3 (odds ratio, 1.83; 95% confidence interval, 1.62 to 2.06) and 4 (odds ratio, 2.33; 95% confidence interval, 1.92 to 2.83 both
<0.001). The stroke risk, in contrast, was lower for patients with CKD stages 4 (odds ratio, 0.23; 95% confidence interval, 0.16 to 0.33) and 5 (odds ratio, 0.24; 95% confidence interval, 0.15 to 0.39; both
<0.001). Lengths of hospital stay were, on average, 1.2-fold longer, whereas reimbursements were, on average, only 1.03-fold higher in patients who suffered from CKD.
This analysis illustrates for the first time on a nationwide basis the association of CKD with adverse outcomes in patients who underwent transcatheter aortic valve implantation. Thus, classification of CKD stages before transcatheter aortic valve implantation is important for appropriate risk stratification.</description><identifier>ISSN: 1555-9041</identifier><identifier>EISSN: 1555-905X</identifier><identifier>DOI: 10.2215/CJN.10471016</identifier><identifier>PMID: 28289067</identifier><language>eng</language><publisher>United States: American Society of Nephrology</publisher><subject>Aged ; Aged, 80 and over ; Aortic Valve - physiopathology ; Aortic Valve - surgery ; Aortic Valve Stenosis - economics ; Aortic Valve Stenosis - mortality ; Aortic Valve Stenosis - physiopathology ; Aortic Valve Stenosis - surgery ; Chi-Square Distribution ; Comorbidity ; Cost-Benefit Analysis ; Databases, Factual ; Female ; Germany - epidemiology ; Health Care Costs ; Hospital Mortality ; Humans ; Insurance, Health, Reimbursement ; Kidney - physiopathology ; Logistic Models ; Male ; Odds Ratio ; Original ; Renal Insufficiency, Chronic - economics ; Renal Insufficiency, Chronic - epidemiology ; Renal Insufficiency, Chronic - mortality ; Renal Insufficiency, Chronic - physiopathology ; Risk Assessment ; Risk Factors ; Time Factors ; Transcatheter Aortic Valve Replacement - adverse effects ; Transcatheter Aortic Valve Replacement - economics ; Transcatheter Aortic Valve Replacement - mortality ; Treatment Outcome</subject><ispartof>Clinical journal of the American Society of Nephrology, 2017-05, Vol.12 (5), p.718-726</ispartof><rights>Copyright © 2017 by the American Society of Nephrology.</rights><rights>Copyright © 2017 by the American Society of Nephrology 2017</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c384t-89abdf8fcb2d061b3700ca83bfe476774e8b18aedfba5210cbe30fbd5c8477c83</citedby><cites>FETCH-LOGICAL-c384t-89abdf8fcb2d061b3700ca83bfe476774e8b18aedfba5210cbe30fbd5c8477c83</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5477218/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5477218/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,315,728,781,785,886,27929,27930,53796,53798</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28289067$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lüders, Florian</creatorcontrib><creatorcontrib>Kaier, Klaus</creatorcontrib><creatorcontrib>Kaleschke, Gerrit</creatorcontrib><creatorcontrib>Gebauer, Katrin</creatorcontrib><creatorcontrib>Meyborg, Matthias</creatorcontrib><creatorcontrib>Malyar, Nasser M</creatorcontrib><creatorcontrib>Freisinger, Eva</creatorcontrib><creatorcontrib>Baumgartner, Helmut</creatorcontrib><creatorcontrib>Reinecke, Holger</creatorcontrib><creatorcontrib>Reinöhl, Jochen</creatorcontrib><title>Association of CKD with Outcomes Among Patients Undergoing Transcatheter Aortic Valve Implantation</title><title>Clinical journal of the American Society of Nephrology</title><addtitle>Clin J Am Soc Nephrol</addtitle><description>Despitethe multiple depicted associations of CKD with reduced cardiovascular and overall prognoses, the association of CKD with outcome of patients undergoing transcatheter aortic valve implantation has still not been well described.
Data from all hospitalized patients who underwent transcatheter aortic valve implantation procedures between January 1, 2010 and December 31, 2013 in Germany were evaluated regarding influence of CKD, even in the earlier stages, on morbidity, in-hospital outcomes, and costs.
A total of 28,716 patients were treated with transcatheter aortic valve implantation. A total of 11,189 (39.0%) suffered from CKD. Patients with CKD were predominantly women; had higher rates of comorbidities, such as coronary artery disease, heart failure at New York Heart Association 3/4, peripheral artery disease, and diabetes; and had a 1.3-fold higher estimated logistic European System for Cardiac Operative Risk Evaluation value. In-hospital mortality was independently associated with CKD stage ≥3 (up to odds ratio, 1.71; 95% confidence interval, 1.35 to 2.17;
<0.05), bleeding was independently associated with CKD stage ≥4 (up to odds ratio, 1.82; 95% confidence interval, 1.47 to 2.24;
<0.001), and AKI was independently associated with CKD stages 3 (odds ratio, 1.83; 95% confidence interval, 1.62 to 2.06) and 4 (odds ratio, 2.33; 95% confidence interval, 1.92 to 2.83 both
<0.001). The stroke risk, in contrast, was lower for patients with CKD stages 4 (odds ratio, 0.23; 95% confidence interval, 0.16 to 0.33) and 5 (odds ratio, 0.24; 95% confidence interval, 0.15 to 0.39; both
<0.001). Lengths of hospital stay were, on average, 1.2-fold longer, whereas reimbursements were, on average, only 1.03-fold higher in patients who suffered from CKD.
This analysis illustrates for the first time on a nationwide basis the association of CKD with adverse outcomes in patients who underwent transcatheter aortic valve implantation. Thus, classification of CKD stages before transcatheter aortic valve implantation is important for appropriate risk stratification.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Aortic Valve - physiopathology</subject><subject>Aortic Valve - surgery</subject><subject>Aortic Valve Stenosis - economics</subject><subject>Aortic Valve Stenosis - mortality</subject><subject>Aortic Valve Stenosis - physiopathology</subject><subject>Aortic Valve Stenosis - surgery</subject><subject>Chi-Square Distribution</subject><subject>Comorbidity</subject><subject>Cost-Benefit Analysis</subject><subject>Databases, Factual</subject><subject>Female</subject><subject>Germany - epidemiology</subject><subject>Health Care Costs</subject><subject>Hospital Mortality</subject><subject>Humans</subject><subject>Insurance, Health, Reimbursement</subject><subject>Kidney - physiopathology</subject><subject>Logistic Models</subject><subject>Male</subject><subject>Odds Ratio</subject><subject>Original</subject><subject>Renal Insufficiency, Chronic - economics</subject><subject>Renal Insufficiency, Chronic - epidemiology</subject><subject>Renal Insufficiency, Chronic - mortality</subject><subject>Renal Insufficiency, Chronic - physiopathology</subject><subject>Risk Assessment</subject><subject>Risk Factors</subject><subject>Time Factors</subject><subject>Transcatheter Aortic Valve Replacement - adverse effects</subject><subject>Transcatheter Aortic Valve Replacement - economics</subject><subject>Transcatheter Aortic Valve Replacement - mortality</subject><subject>Treatment Outcome</subject><issn>1555-9041</issn><issn>1555-905X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpVkU1PAyEQhonRaK3ePBuOHlwFFhZ6MWnqV7WxHtR4I8CyLWZ3qUA1_nvXjzZ6msnMM-_M5AXgAKMTQjA7Hd3cnWBEOUa42AA9zBjLBog9b65zinfAbowvCFGaE7YNdoggYoAK3gN6GKM3TiXnW-grOLo9h-8uzeF0mYxvbITDxrczeN8Rtk0RPralDTPvutpDUG00Ks1tsgEOfUjOwCdVv1k4bha1atO37B7YqlQd7f5v7IPHy4uH0XU2mV6NR8NJZnJBUyYGSpeVqIwmJSqwzjlCRolcV5bygnNqhcZC2bLSihGMjLY5qnTJjKCcG5H3wdmP7mKpG1ua7tygarkIrlHhQ3rl5P9O6-Zy5t8k6-YJ_hI4-hUI_nVpY5KNi8bW3SfWL6PEgnNGCjrAHXr8g5rgYwy2Wq_BSH7ZIjtb5MqWDj_8e9oaXvmQfwKgeosf</recordid><startdate>20170508</startdate><enddate>20170508</enddate><creator>Lüders, Florian</creator><creator>Kaier, Klaus</creator><creator>Kaleschke, Gerrit</creator><creator>Gebauer, Katrin</creator><creator>Meyborg, Matthias</creator><creator>Malyar, Nasser M</creator><creator>Freisinger, Eva</creator><creator>Baumgartner, Helmut</creator><creator>Reinecke, Holger</creator><creator>Reinöhl, Jochen</creator><general>American Society of Nephrology</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20170508</creationdate><title>Association of CKD with Outcomes Among Patients Undergoing Transcatheter Aortic Valve Implantation</title><author>Lüders, Florian ; Kaier, Klaus ; Kaleschke, Gerrit ; Gebauer, Katrin ; Meyborg, Matthias ; Malyar, Nasser M ; Freisinger, Eva ; Baumgartner, Helmut ; Reinecke, Holger ; Reinöhl, Jochen</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c384t-89abdf8fcb2d061b3700ca83bfe476774e8b18aedfba5210cbe30fbd5c8477c83</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Aortic Valve - physiopathology</topic><topic>Aortic Valve - surgery</topic><topic>Aortic Valve Stenosis - economics</topic><topic>Aortic Valve Stenosis - mortality</topic><topic>Aortic Valve Stenosis - physiopathology</topic><topic>Aortic Valve Stenosis - surgery</topic><topic>Chi-Square Distribution</topic><topic>Comorbidity</topic><topic>Cost-Benefit Analysis</topic><topic>Databases, Factual</topic><topic>Female</topic><topic>Germany - epidemiology</topic><topic>Health Care Costs</topic><topic>Hospital Mortality</topic><topic>Humans</topic><topic>Insurance, Health, Reimbursement</topic><topic>Kidney - physiopathology</topic><topic>Logistic Models</topic><topic>Male</topic><topic>Odds Ratio</topic><topic>Original</topic><topic>Renal Insufficiency, Chronic - economics</topic><topic>Renal Insufficiency, Chronic - epidemiology</topic><topic>Renal Insufficiency, Chronic - mortality</topic><topic>Renal Insufficiency, Chronic - physiopathology</topic><topic>Risk Assessment</topic><topic>Risk Factors</topic><topic>Time Factors</topic><topic>Transcatheter Aortic Valve Replacement - adverse effects</topic><topic>Transcatheter Aortic Valve Replacement - economics</topic><topic>Transcatheter Aortic Valve Replacement - mortality</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lüders, Florian</creatorcontrib><creatorcontrib>Kaier, Klaus</creatorcontrib><creatorcontrib>Kaleschke, Gerrit</creatorcontrib><creatorcontrib>Gebauer, Katrin</creatorcontrib><creatorcontrib>Meyborg, Matthias</creatorcontrib><creatorcontrib>Malyar, Nasser M</creatorcontrib><creatorcontrib>Freisinger, Eva</creatorcontrib><creatorcontrib>Baumgartner, Helmut</creatorcontrib><creatorcontrib>Reinecke, Holger</creatorcontrib><creatorcontrib>Reinöhl, Jochen</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Clinical journal of the American Society of Nephrology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lüders, Florian</au><au>Kaier, Klaus</au><au>Kaleschke, Gerrit</au><au>Gebauer, Katrin</au><au>Meyborg, Matthias</au><au>Malyar, Nasser M</au><au>Freisinger, Eva</au><au>Baumgartner, Helmut</au><au>Reinecke, Holger</au><au>Reinöhl, Jochen</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Association of CKD with Outcomes Among Patients Undergoing Transcatheter Aortic Valve Implantation</atitle><jtitle>Clinical journal of the American Society of Nephrology</jtitle><addtitle>Clin J Am Soc Nephrol</addtitle><date>2017-05-08</date><risdate>2017</risdate><volume>12</volume><issue>5</issue><spage>718</spage><epage>726</epage><pages>718-726</pages><issn>1555-9041</issn><eissn>1555-905X</eissn><abstract>Despitethe multiple depicted associations of CKD with reduced cardiovascular and overall prognoses, the association of CKD with outcome of patients undergoing transcatheter aortic valve implantation has still not been well described.
Data from all hospitalized patients who underwent transcatheter aortic valve implantation procedures between January 1, 2010 and December 31, 2013 in Germany were evaluated regarding influence of CKD, even in the earlier stages, on morbidity, in-hospital outcomes, and costs.
A total of 28,716 patients were treated with transcatheter aortic valve implantation. A total of 11,189 (39.0%) suffered from CKD. Patients with CKD were predominantly women; had higher rates of comorbidities, such as coronary artery disease, heart failure at New York Heart Association 3/4, peripheral artery disease, and diabetes; and had a 1.3-fold higher estimated logistic European System for Cardiac Operative Risk Evaluation value. In-hospital mortality was independently associated with CKD stage ≥3 (up to odds ratio, 1.71; 95% confidence interval, 1.35 to 2.17;
<0.05), bleeding was independently associated with CKD stage ≥4 (up to odds ratio, 1.82; 95% confidence interval, 1.47 to 2.24;
<0.001), and AKI was independently associated with CKD stages 3 (odds ratio, 1.83; 95% confidence interval, 1.62 to 2.06) and 4 (odds ratio, 2.33; 95% confidence interval, 1.92 to 2.83 both
<0.001). The stroke risk, in contrast, was lower for patients with CKD stages 4 (odds ratio, 0.23; 95% confidence interval, 0.16 to 0.33) and 5 (odds ratio, 0.24; 95% confidence interval, 0.15 to 0.39; both
<0.001). Lengths of hospital stay were, on average, 1.2-fold longer, whereas reimbursements were, on average, only 1.03-fold higher in patients who suffered from CKD.
This analysis illustrates for the first time on a nationwide basis the association of CKD with adverse outcomes in patients who underwent transcatheter aortic valve implantation. Thus, classification of CKD stages before transcatheter aortic valve implantation is important for appropriate risk stratification.</abstract><cop>United States</cop><pub>American Society of Nephrology</pub><pmid>28289067</pmid><doi>10.2215/CJN.10471016</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central; Alma/SFX Local Collection |
| subjects | Aged Aged, 80 and over Aortic Valve - physiopathology Aortic Valve - surgery Aortic Valve Stenosis - economics Aortic Valve Stenosis - mortality Aortic Valve Stenosis - physiopathology Aortic Valve Stenosis - surgery Chi-Square Distribution Comorbidity Cost-Benefit Analysis Databases, Factual Female Germany - epidemiology Health Care Costs Hospital Mortality Humans Insurance, Health, Reimbursement Kidney - physiopathology Logistic Models Male Odds Ratio Original Renal Insufficiency, Chronic - economics Renal Insufficiency, Chronic - epidemiology Renal Insufficiency, Chronic - mortality Renal Insufficiency, Chronic - physiopathology Risk Assessment Risk Factors Time Factors Transcatheter Aortic Valve Replacement - adverse effects Transcatheter Aortic Valve Replacement - economics Transcatheter Aortic Valve Replacement - mortality Treatment Outcome |
| title | Association of CKD with Outcomes Among Patients Undergoing Transcatheter Aortic Valve Implantation |
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