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'07 to '14 Saw Drop in Proportion Needing Dialysis After TAVI

Need for new dialysis after TAVI linked to increased risk of mortality at 30-days and four years


WEDNESDAY, Aug. 16, 2017 (HealthDay News) -- From 2007 to 2014 there was a decrease in the proportion of patients needing dialysis after transcatheter aortic valve implantation (TAVI), according to a study published online Aug. 2 in JACC: Cardiovascular Interventions.

Charles J. Ferro, M.D., from Queen Elizabeth Hospital in Birmingham, U.K., and colleagues examined risk factors for post-TAVI dialysis using data from the U.K. TAVI Registry for all TAVI procedures performed within the United Kingdom (2007 to 2014). The authors prospectively collected data on 6,464 patients, with a median follow-up of 625 days.

The researchers found that a constant, 1.8 percent of patients were on dialysis before TAVI. From 2007/2008 to 2013/2014, the proportion of patients newly needing dialysis after TAVI decreased from 6.1 to 2.3 percent. There was an independent correlation for the risk of new dialysis requirement after TAVI with lower baseline renal function, year of procedure, impaired left ventricular function, diabetes, use of an Edwards valve, a non-transfemoral approach, need for open surgery, and moderate-to-severe aortic regurgitation after the procedure. Compared to patients without dialysis requirement, requirement for new dialysis after TAVI correlated with increased mortality at 30 days and four years (hazard ratios, 6.44 and 3.54, respectively; both P < 0.001).

"The proportion of patients needing dialysis after TAVI has decreased over time," the authors write. "Post-TAVI dialysis is associated with increased mortality."

Several authors disclosed financial ties to the medical device and medical technology industries.

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