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Open Access 01-06-2023 | Transcatheter Aortic Valve Implantation | Original Paper

Effect of periprocedural furosemide-induced diuresis with matched isotonic intravenous hydration in patients with chronic kidney disease undergoing transcatheter aortic valve implantation

Authors: Lisa Voigtländer-Buschmann, Sarina Schäfer, Christian Schmidt-Lauber, Jessica Weimann, Mina Shenas, Julian Giraldo Cortes, Piotr Mariusz Kuta, Tanja Zeller, Raphael Twerenbold, Moritz Seiffert, Niklas Schofer, Yvonne Schneeberger, Andreas Schäfer, Johannes Schirmer, Hermann Reichenspurner, Stefan Blankenberg, Lenard Conradi, Ulrich Schäfer

Published in: Clinical Research in Cardiology

Abstract

Background

Acute kidney injury (AKI) after transcatheter aortic valve implantation (TAVI) is a serious complication which is associated with increased mortality. The RenalGuard system was developed to reduce the risk of AKI after contrast media exposition by furosemide-induced diuresis with matched isotonic intravenous hydration. The aim of this study was to examine the effect of the RenalGuard system on the occurrence of AKI after TAVI in patients with chronic kidney disease.

Methods

The present study is a single-center randomized trial including patients with severe aortic valve stenosis undergoing TAVI. Overall, a total of 100 patients treated by TAVI between January 2017 and August 2018 were randomly assigned to a periprocedural treatment with the RenalGuard system or standard treatment by pre- and postprocedural intravenous hydration. Primary endpoint was the occurrence of AKI after TAVI, and secondary endpoints were assessed according to valve academic research consortium 2 criteria.

Results

Overall, the prevalence of AKI was 18.4% (n = 18). The majority of these patients developed mild AKI according to stage 1. Comparing RenalGuard to standard therapy, no significant differences were observed in the occurrence of AKI (RenalGuard: 21.3%; control group: 15.7%; p = 0.651). In addition, there were no differences between the groups with regard to 30-day and 12-month mortality and procedure-associated complication rates.

Conclusion

In this randomized trial, we did not detect a reduction in AKI after TAVI by using the RenalGuard system. A substantial number of patients with chronic kidney disease developed AKI after TAVI, whereas the majority presented with mild AKI according to stage 1 (ClinicalTrials.gov number NCT04537325).

Graphical abstract

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Title: Effect of periprocedural furosemide-induced diuresis with matched isotonic intravenous hydration in patients with chronic kidney disease undergoing transcatheter aortic valve implantation
Authors: Lisa Voigtländer-Buschmann
Sarina Schäfer
Christian Schmidt-Lauber
Jessica Weimann
Mina Shenas
Julian Giraldo Cortes
Piotr Mariusz Kuta
Tanja Zeller
Raphael Twerenbold
Moritz Seiffert
Niklas Schofer
Yvonne Schneeberger
Andreas Schäfer
Johannes Schirmer
Hermann Reichenspurner
Stefan Blankenberg
Lenard Conradi
Ulrich Schäfer
Publication date: 01-06-2023
Publisher: Springer Berlin Heidelberg
Keywords: Transcatheter Aortic Valve Implantation
Acute Kidney Injury
Acute Kidney Injury
Chronic Kidney Disease
Furosemide
Published in: Clinical Research in Cardiology
Print ISSN: 1861-0684
Electronic ISSN: 1861-0692
DOI: https://doi.org/10.1007/s00392-023-02234-z

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Effect of periprocedural furosemide-induced diuresis with matched isotonic intravenous hydration in patients with chronic kidney disease undergoing transcatheter aortic valve implantation

Abstract

Background

Methods

Results

Conclusion

Graphical abstract

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ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

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New intervention for STEMI-related cardiogenic shock

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