RenalGuard System for the prevention of acute kidney injury in patients undergoing transcatheter aortic valve implantation

EuroIntervention. 2016 Apr 8;11(14):e1658-61. doi: 10.4244/EIJV11I14A317.

Abstract

Aims: We aimed to assess whether the RenalGuard™ System is effective in preventing acute kidney injury (AKI) following transcatheter aortic valve implantation (TAVI).

Methods and results: Forty-eight consecutive patients with chronic kidney disease (CKD) scheduled for TAVI were assigned to: 1) hydration with sodium bicarbonate solution (Control group), or 2) hydration with RenalGuard Therapy (RenalGuard group). Hypotension was defined as periprocedural mean blood pressure <55 mmHg. The primary endpoint was the occurrence of AKI (i.e., an increase of ≥0.3 mg/dL in the serum creatinine concentration at seven days). AKI occurred in 10/26 (38.5%) patients in the Control group and in 1/22 (4.5%) patients in the RenalGuard group (p=0.005, odds ratio [OR] 0.076, 95% confidence interval [CI]: 0.009-0.66). RenalGuard Therapy protected against AKI (OR 0.71, 95% CI: 0.07-0.775, p=0.026), whereas post-procedural hypotension (OR 3.88, 95% CI: 1.06-14.24, p=0.040), and contrast media volume (OR 3.65, 95% CI: 1.15-5.75, p=0.043) increased the risk of AKI.

Conclusions: This non-randomised pilot study suggests that RenalGuard Therapy may be effective in preventing AKI in CKD patients undergoing TAVI.

MeSH terms

  • Acute Kidney Injury / physiopathology
  • Acute Kidney Injury / prevention & control*
  • Acute Kidney Injury / surgery*
  • Aortic Valve Stenosis / therapy*
  • Cardiac Catheterization / methods
  • Creatinine / blood
  • Female
  • Heart Valve Prosthesis Implantation* / adverse effects
  • Heart Valve Prosthesis Implantation* / methods
  • Humans
  • Male
  • Risk Factors
  • Transcatheter Aortic Valve Replacement* / methods
  • Treatment Outcome

Substances

  • Creatinine