Influence of different stages of chronic kidney disease on prognosis of patients with aortic stenosis after transcatheter aortic valve replacement: A systematic review and meta-analysis_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

WANG Jialu ¹ , LIU Shidong ² , HAN Xiangxiang ¹ , LI Yimeng ¹ , CONG Qianyue ¹ , AN Hengjun ¹ ,  SONG Bing ²

1. The First Clinical Medical College of Lanzhou University, Lanzhou, 730000, P. R. China;
2. Department of Cardiovascular Surgery, The First Hospital of Lanzhou University, Lanzhou, 730000, P. R. China;

Corresponding author：

SONG Bing, Email: songbingldyy@163.com

Keywords：

Transcatheter aortic valve replacement; chronic kidney disease; prognosis; systematic review/meta-analysis

DOI：

10.7507/1007-4848.202011076

Video：

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Objective To systematically review the impact of chronic kidney disease (CKD) at different stages on prognosis of transcatheter aortic valve replacement (TAVR).Methods Databases including PubMed, the Cochrane Library, EMbase, Web of Science, CNKI, Wanfang and the Chinese Biomedical Literature Database (CBM) were searched by computer to collect cohort studies on impact of different stages of CKD on prognosis of TAVR from inception to July 2020. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies, and then, meta-analysis was performed by using Stata 15.0 software. Risk of study bias was assessed using the Newcastle-Ottawa Scale (NOS).Results A total of 17 cohort studies were included with NOS score≥6 points. The results of meta-analysis indicated that: compared with the patients without CKD, all-cause mortality of CKD stage 3 patients at 30 day (RR=1.29, 95%CI 1.22-1.37, P<0.001) and 1 year (RR=1.24, 95%CI 1.19-1.28, P<0.001), all-cause mortality of CKD stage 4 patients at 30 day (RR=2.10, 95%CI 1.90-2.31, P<0.001) and 1 year (RR=1.89, 95%CI 1.62-2.19, P<0.001), and all-cause mortality of CKD stage 5 patients at 30 day (RR=2.22, 95%CI 1.62-2.19, P<0.001) and 1 year (RR=2.24, 95%CI 1.75-2.87, P<0.001) were significantly increased and were associated with the severity of CKD. The occurrence rates of 1-year cardiovascular mortality, postoperative acute kidney injury and bleeding events were all higher in patients with CKD.Conclusion CKD at stages 3, 4 and 5 is associated with increased all-cause mortality after TAVR, and the higher the stage of CKD is, the higher the risk of all-cause mortality at 30-day and 1-year follow-up is. Due to limited quality and quantity of the included studies, more high-quality studies are required to verify above conclusions.

Citation： WANG Jialu, LIU Shidong, HAN Xiangxiang, LI Yimeng, CONG Qianyue, AN Hengjun, SONG Bing. Influence of different stages of chronic kidney disease on prognosis of patients with aortic stenosis after transcatheter aortic valve replacement: A systematic review and meta-analysis. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2022, 29(8): 1049-1059. doi: 10.7507/1007-4848.202011076 Copy

1.	Van Hemelrijck M, Taramasso M, De Carlo C, et al. Recent advances in understanding and managing aortic stenosis. F1000Res, 2018, 7: 58.
2.	高润霖. 中国心瓣膜病现状. 华西医学, 2018, 33(2): 127-131.
3.	王建安. 经导管主动脉瓣置换术适应证的变迁. 华西医学, 2018, 33(2): 140-144.
4.	党梦秋, 范嘉祺, 朱齐丰, 等. 《经导管主动脉瓣置换术中国专家共识(2020 更新版)》解读. 心电与循环, 2021, 40(1): 1-5.
5.	Carabello BA. Transcatheter aortic-valve implantation for aortic stenosis in patients who cannot undergo surgery. Curr Cardiol Rep, 2011, 13(3): 173-174.
6.	Zhang L, Wang F, Wang L, et al. Prevalence of chronic kidney disease in China: A cross-sectional survey. Lancet, 2012, 379(9818): 815-822.
7.	Rattanawong P, Kanitsoraphan C, Kewcharoen J, et al. Chronic kidney disease is associated with increased mortality and procedural complications in transcatheter aortic valve replacement: A systematic review and meta-analysis. Catheter Cardiovasc Interv, 2019, 94(3): E116-E127.
8.	Gupta T, Goel K, Kolte D, et al. Association of chronic kidney disease with in-hospital outcomes of transcatheter aortic valve replacement. JACC Cardiovasc Interv, 2017, 10(20): 2050-2060.
9.	Allende R, Webb JG, Munoz-Garcia AJ, et al. Advanced chronic kidney disease in patients undergoing transcatheter aortic valve implantation: Insights on clinical outcomes and prognostic markers from a large cohort of patients. Eur Heart J, 2014, 35(38): 2685-2696.
10.	Roques F, Nashef SA, Michel P, et al. Risk factors and outcome in European cardiac surgery: Analysis of the EuroSCORE multinational database of 19030 patients. Eur J Cardiothorac Surg, 1999, 15(6): 816-822.
11.	Jamieson WR, Edwards FH, Schwartz M, et al. Risk stratification for cardiac valve replacement. National Cardiac Surgery Database. Database Committee of The Society of Thoracic Surgeons. Ann Thorac Surg, 1999, 67(4): 943-951.
12.	Herzog CA, Ma JZ, Collins AJ. Long-term survival of dialysis patients in the United States with prosthetic heart valves: Should ACC/AHA practice guidelines on valve selection be modified? Circulation, 2002, 105(11): 1336-1341.
13.	Wessely M, Rau S, Lange P, et al. Chronic kidney disease is not associated with a higher risk for mortality or acute kidney injury in transcatheter aortic valve implantation. Nephrol Dial Transplant, 2012, 27(9): 3502-3508.
14.	Dumonteil N, van der Boon RM, Tchetche D, et al. Impact of preoperative chronic kidney disease on short- and long-term outcomes after transcatheter aortic valve implantation: A Pooled-RotterdAm-Milano-Toulouse In Collaboration Plus (PRAGMATIC-Plus) initiative substudy. Am Heart J, 2013, 165(5): 752-760.
15.	Goebel N, Baumbach H, Ahad S, et al. Transcatheter aortic valve replacement: Does kidney function affect outcome? Ann Thorac Surg, 2013, 96(2): 507-512.
16.	Nguyen TC, Babaliaros VC, Razavi SA, et al. Impact of varying degrees of renal dysfunction on transcatheter and surgical aortic valve replacement. J Thorac Cardiovasc Surg, 2013, 146(6): 1399-1406.
17.	Ferro CJ, Chue CD, de Belder MA, et al. Impact of renal function on survival after transcatheter aortic valve implantation (TAVI): An analysis of the UK TAVI Registry. Heart, 2015, 101(7): 546-552.
18.	Rahman MS, Sharma R, Brecker SJD. Transcatheter aortic valve implantation in patients with pre-existing chronic kidney disease. Int J Cardiol Heart Vasc, 2015, 8: 9-18.
19.	Codner P, Levi A, Gargiulo G, et al. Impact of renal dysfunction on results of transcatheter aortic valve replacement outcomes in a large multicenter cohort. Am J Cardiol, 2016, 118(12): 1888-1896.
20.	Thourani VH, Forcillo J, Beohar N, et al. Impact of preoperative chronic kidney disease in 2,531 high-risk and inoperable patients undergoing transcatheter aortic valve replacement in the PARTNER trial. Ann Thorac Surg, 2016, 102(4): 1172-1180.
21.	Villablanca PA, Mathew V, Thourani VH, et al. A meta-analysis and meta-regression of long-term outcomes of transcatheter versus surgical aortic valve replacement for severe aortic stenosis. Int J Cardiol, 2016, 225: 234-243.
22.	Hansen JW, Foy A, Yadav P, et al. Death and dialysis after transcatheter aortic valve replacement: An analysis of the STS/ACC TVT Registry. JACC Cardiovasc Interv, 2017, 10(20): 2064-2075.
23.	Lüders F, Kaier K, Kaleschke G, et al. Association of CKD with outcomes among patients undergoing transcatheter aortic valve implantation. Clin J Am Soc Nephrol, 2017, 12(5): 718-726.
24.	Franzone A, Stortecky S, Pilgrim T, et al. Incidence and impact of renal dysfunction on clinical outcomes after transcatheter aortic valve implantation. Int J Cardiol, 2018, 250: 73-79.
25.	Bandyopadhyay D, Sartori S, Baber U, et al. The impact of chronic kidney disease in women undergoing transcatheter aortic valve replacement: Analysis from the Women's INternational Transcatheter Aortic Valve Implantation (WIN-TAVI) Registry. Catheter Cardiovasc Interv, 2020, 96(1): 198-207.
26.	Gracia E, Wang TY, Callahan S, et al. Impact of severity of chronic kidney disease on management and outcomes following transcatheter aortic valve replacement with newer-generation transcatheter valves. J Invasive Cardiol, 2020, 32(1): 25-29.
27.	Li SX, Patel NK, Flannery LD, et al. Impact of bleeding after transcatheter aortic valve replacement in patients with chronic kidney disease. Catheter Cardiovasc Interv, 2021, 97(1): E172-E178.
28.	Yap JJ, Tay JC, Ewe SH, et al. Impact of chronic kidney disease on outcomes in transcatheter aortic valve implantation. Ann Acad Med Singap, 2020, 49(5): 273-284.
29.	D'Ascenzo F, Moretti C, Salizzoni S, et al. 30 days and midterm outcomes of patients undergoing percutaneous replacement of aortic valve according to their renal function: A multicenter study. Int J Cardiol, 2013, 167(4): 1514-1518.
30.	Yamamoto M, Hayashida K, Mouillet G, et al. Prognostic value of chronic kidney disease after transcatheter aortic valve implantation. J Am Coll Cardiol, 2013, 62(10): 869-877.
31.	Pineda AM, Kevin Harrison J, Kleiman NS, et al. Clinical impact of baseline chronic kidney disease in patients undergoing transcatheter or surgical aortic valve replacement. Catheter Cardiovasc Interv, 2019, 93(4): 740-748.
32.	上海慢性肾脏病早发现及规范化诊治与示范项目专家组. 慢性肾脏病筛查诊断及防治指南. 中国实用内科杂志, 2017, 37(1): 28-34.
33.	裴汉军, 吴永健, 杨跃进, 等. 过渡性经皮球囊主动脉瓣成形术治疗危重主动脉瓣狭窄的早期效果. 中华心血管病杂志, 2015, 43(1): 34-38.
34.	施浩, 王首正, 谢涌泉. 未来已来: 经导管主动脉瓣置换术在中低危患者的临床应用现状和前景. 中国胸心血管外科临床杂志, 2019, 26(11): 1060-1062.
35.	韩雅玲, 徐凯. 中国经导管瓣膜病介入治疗现状. 华西医学, 2020, 35(9): 1035-1038.
36.	Bohbot Y, Candellier A, Diouf M, et al. Severe aortic stenosis and chronic kidney disease: Outcomes and impact of aortic valve replacement. J Am Heart Assoc, 2020, 9(19): e017190.
37.	黄乾海, 刘前进, 张华坤, 等. 经导管主动脉瓣置换术治疗重度主动脉瓣狭窄. 华西医学, 2020, 35(4): 494-502.
38.	Lutz J, Menke J, Sollinger D, et al. Haemostasis in chronic kidney disease. Nephrol Dial Transplant, 2014, 29(1): 29-40.
39.	Thongprayoon C, Cheungpasitporn W, Srivali N, et al. AKI after transcatheter or surgical aortic valve replacement. J Am Soc Nephrol, 2016, 27(6): 1854-1860.
40.	Thongprayoon C, Cheungpasitporn W, Srivali N, et al. Incidence and risk factors of acute kidney injury following transcatheter aortic valve replacement. Nephrology (Carlton), 2016, 21(12): 1041-1046.
41.	叶楠, 张燕, 程虹, 等. 成人心外科手术后急性肾损伤的评分预警系统创建. 中国胸心血管外科临床杂志, 2013, 20(4): 396-401.
42.	王旭冬, 车妙琳, 谢波, 等. 急性肾损伤定义及分期系统评估心脏手术患者预后的临床价值. 中国胸心血管外科临床杂志, 2012, 19(6): 619-623.

1. Van Hemelrijck M, Taramasso M, De Carlo C, et al. Recent advances in understanding and managing aortic stenosis. F1000Res, 2018, 7: 58.
2. 高润霖. 中国心瓣膜病现状. 华西医学, 2018, 33(2): 127-131.
3. 王建安. 经导管主动脉瓣置换术适应证的变迁. 华西医学, 2018, 33(2): 140-144.
4. 党梦秋, 范嘉祺, 朱齐丰, 等. 《经导管主动脉瓣置换术中国专家共识(2020 更新版)》解读. 心电与循环, 2021, 40(1): 1-5.
5. Carabello BA. Transcatheter aortic-valve implantation for aortic stenosis in patients who cannot undergo surgery. Curr Cardiol Rep, 2011, 13(3): 173-174.
6. Zhang L, Wang F, Wang L, et al. Prevalence of chronic kidney disease in China: A cross-sectional survey. Lancet, 2012, 379(9818): 815-822.
7. Rattanawong P, Kanitsoraphan C, Kewcharoen J, et al. Chronic kidney disease is associated with increased mortality and procedural complications in transcatheter aortic valve replacement: A systematic review and meta-analysis. Catheter Cardiovasc Interv, 2019, 94(3): E116-E127.
8. Gupta T, Goel K, Kolte D, et al. Association of chronic kidney disease with in-hospital outcomes of transcatheter aortic valve replacement. JACC Cardiovasc Interv, 2017, 10(20): 2050-2060.
9. Allende R, Webb JG, Munoz-Garcia AJ, et al. Advanced chronic kidney disease in patients undergoing transcatheter aortic valve implantation: Insights on clinical outcomes and prognostic markers from a large cohort of patients. Eur Heart J, 2014, 35(38): 2685-2696.
10. Roques F, Nashef SA, Michel P, et al. Risk factors and outcome in European cardiac surgery: Analysis of the EuroSCORE multinational database of 19030 patients. Eur J Cardiothorac Surg, 1999, 15(6): 816-822.
11. Jamieson WR, Edwards FH, Schwartz M, et al. Risk stratification for cardiac valve replacement. National Cardiac Surgery Database. Database Committee of The Society of Thoracic Surgeons. Ann Thorac Surg, 1999, 67(4): 943-951.
12. Herzog CA, Ma JZ, Collins AJ. Long-term survival of dialysis patients in the United States with prosthetic heart valves: Should ACC/AHA practice guidelines on valve selection be modified? Circulation, 2002, 105(11): 1336-1341.
13. Wessely M, Rau S, Lange P, et al. Chronic kidney disease is not associated with a higher risk for mortality or acute kidney injury in transcatheter aortic valve implantation. Nephrol Dial Transplant, 2012, 27(9): 3502-3508.
14. Dumonteil N, van der Boon RM, Tchetche D, et al. Impact of preoperative chronic kidney disease on short- and long-term outcomes after transcatheter aortic valve implantation: A Pooled-RotterdAm-Milano-Toulouse In Collaboration Plus (PRAGMATIC-Plus) initiative substudy. Am Heart J, 2013, 165(5): 752-760.
15. Goebel N, Baumbach H, Ahad S, et al. Transcatheter aortic valve replacement: Does kidney function affect outcome? Ann Thorac Surg, 2013, 96(2): 507-512.
16. Nguyen TC, Babaliaros VC, Razavi SA, et al. Impact of varying degrees of renal dysfunction on transcatheter and surgical aortic valve replacement. J Thorac Cardiovasc Surg, 2013, 146(6): 1399-1406.
17. Ferro CJ, Chue CD, de Belder MA, et al. Impact of renal function on survival after transcatheter aortic valve implantation (TAVI): An analysis of the UK TAVI Registry. Heart, 2015, 101(7): 546-552.
18. Rahman MS, Sharma R, Brecker SJD. Transcatheter aortic valve implantation in patients with pre-existing chronic kidney disease. Int J Cardiol Heart Vasc, 2015, 8: 9-18.
19. Codner P, Levi A, Gargiulo G, et al. Impact of renal dysfunction on results of transcatheter aortic valve replacement outcomes in a large multicenter cohort. Am J Cardiol, 2016, 118(12): 1888-1896.
20. Thourani VH, Forcillo J, Beohar N, et al. Impact of preoperative chronic kidney disease in 2,531 high-risk and inoperable patients undergoing transcatheter aortic valve replacement in the PARTNER trial. Ann Thorac Surg, 2016, 102(4): 1172-1180.
21. Villablanca PA, Mathew V, Thourani VH, et al. A meta-analysis and meta-regression of long-term outcomes of transcatheter versus surgical aortic valve replacement for severe aortic stenosis. Int J Cardiol, 2016, 225: 234-243.
22. Hansen JW, Foy A, Yadav P, et al. Death and dialysis after transcatheter aortic valve replacement: An analysis of the STS/ACC TVT Registry. JACC Cardiovasc Interv, 2017, 10(20): 2064-2075.
23. Lüders F, Kaier K, Kaleschke G, et al. Association of CKD with outcomes among patients undergoing transcatheter aortic valve implantation. Clin J Am Soc Nephrol, 2017, 12(5): 718-726.
24. Franzone A, Stortecky S, Pilgrim T, et al. Incidence and impact of renal dysfunction on clinical outcomes after transcatheter aortic valve implantation. Int J Cardiol, 2018, 250: 73-79.
25. Bandyopadhyay D, Sartori S, Baber U, et al. The impact of chronic kidney disease in women undergoing transcatheter aortic valve replacement: Analysis from the Women's INternational Transcatheter Aortic Valve Implantation (WIN-TAVI) Registry. Catheter Cardiovasc Interv, 2020, 96(1): 198-207.
26. Gracia E, Wang TY, Callahan S, et al. Impact of severity of chronic kidney disease on management and outcomes following transcatheter aortic valve replacement with newer-generation transcatheter valves. J Invasive Cardiol, 2020, 32(1): 25-29.
27. Li SX, Patel NK, Flannery LD, et al. Impact of bleeding after transcatheter aortic valve replacement in patients with chronic kidney disease. Catheter Cardiovasc Interv, 2021, 97(1): E172-E178.
28. Yap JJ, Tay JC, Ewe SH, et al. Impact of chronic kidney disease on outcomes in transcatheter aortic valve implantation. Ann Acad Med Singap, 2020, 49(5): 273-284.
29. D'Ascenzo F, Moretti C, Salizzoni S, et al. 30 days and midterm outcomes of patients undergoing percutaneous replacement of aortic valve according to their renal function: A multicenter study. Int J Cardiol, 2013, 167(4): 1514-1518.
30. Yamamoto M, Hayashida K, Mouillet G, et al. Prognostic value of chronic kidney disease after transcatheter aortic valve implantation. J Am Coll Cardiol, 2013, 62(10): 869-877.
31. Pineda AM, Kevin Harrison J, Kleiman NS, et al. Clinical impact of baseline chronic kidney disease in patients undergoing transcatheter or surgical aortic valve replacement. Catheter Cardiovasc Interv, 2019, 93(4): 740-748.
32. 上海慢性肾脏病早发现及规范化诊治与示范项目专家组. 慢性肾脏病筛查诊断及防治指南. 中国实用内科杂志, 2017, 37(1): 28-34.
33. 裴汉军, 吴永健, 杨跃进, 等. 过渡性经皮球囊主动脉瓣成形术治疗危重主动脉瓣狭窄的早期效果. 中华心血管病杂志, 2015, 43(1): 34-38.
34. 施浩, 王首正, 谢涌泉. 未来已来: 经导管主动脉瓣置换术在中低危患者的临床应用现状和前景. 中国胸心血管外科临床杂志, 2019, 26(11): 1060-1062.
35. 韩雅玲, 徐凯. 中国经导管瓣膜病介入治疗现状. 华西医学, 2020, 35(9): 1035-1038.
36. Bohbot Y, Candellier A, Diouf M, et al. Severe aortic stenosis and chronic kidney disease: Outcomes and impact of aortic valve replacement. J Am Heart Assoc, 2020, 9(19): e017190.
37. 黄乾海, 刘前进, 张华坤, 等. 经导管主动脉瓣置换术治疗重度主动脉瓣狭窄. 华西医学, 2020, 35(4): 494-502.
38. Lutz J, Menke J, Sollinger D, et al. Haemostasis in chronic kidney disease. Nephrol Dial Transplant, 2014, 29(1): 29-40.
39. Thongprayoon C, Cheungpasitporn W, Srivali N, et al. AKI after transcatheter or surgical aortic valve replacement. J Am Soc Nephrol, 2016, 27(6): 1854-1860.
40. Thongprayoon C, Cheungpasitporn W, Srivali N, et al. Incidence and risk factors of acute kidney injury following transcatheter aortic valve replacement. Nephrology (Carlton), 2016, 21(12): 1041-1046.
41. 叶楠, 张燕, 程虹, 等. 成人心外科手术后急性肾损伤的评分预警系统创建. 中国胸心血管外科临床杂志, 2013, 20(4): 396-401.
42. 王旭冬, 车妙琳, 谢波, 等. 急性肾损伤定义及分期系统评估心脏手术患者预后的临床价值. 中国胸心血管外科临床杂志, 2012, 19(6): 619-623.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Influence of different stages of chronic kidney disease on prognosis of patients with aortic stenosis after transcatheter aortic valve replacement: A systematic review and meta-analysis

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