Acute kidney injury (AKI) following acute coronary syndrome (ACS) is associated with prolonged hospital stay and worse prognosis at followup. However, serum creatinine level increase can either be transient or permanent. At present, retrospective studies show transient AKI patients present similar survival rate to patients with no AKI. The prognostic implications of transient and persistent...
Prognostic Impact of Acute Kidney Injury Following Tricuspid Transcatheter Edge-to-Edge Repair
Tricuspid failure (TF) mostly affects the elderly and, because of this, is associated with comorbidities that increase surgical risk. Tricuspid edge to edge repair (TEER) has surged as a valid alternative for the mitral valve in high-risk patients and, at present, is increasingly being used for tricuspids. One of the complications following TEER is acute...
TEATE Trial: Urine Alkalinization as a Target to Prevent Contrast-Associated Kidney Injury
Acute kidney injury related to iodinated contrast significantly increases morbidity and mortality after angiography or angioplasty. According to registries, its prevalence can vary from 2% in low-risk population to up to 50% in high-risk subjects. Its risk factors include previous renal failure, diabetes, age, and the amount/type of contrast used. As a preventive measure, international...
Renal Guard System to Prevent Contrast Induced Acute Kidney Injury in Patients at High Risk Contrast Induced Acute Kidney Injury
Contrast Induced Acute Kidney Injury (CI-AKI) is associated to increased costs and unfavorable results after hemodynamic procedures. Its incidence ranges between 2% and 7% according to the most recent literature. Multiple protection strategies have been analyzed in randomized studies, but no therapy has shown clear benefits. The RenalGuard (RG) is a device that uses furosemide-induced diuresis with...
Incidence, Predictors, and Results of Acute Kidney Injury in Patients Undergoing TAVR
Acute kidney injury after transcatheter aortic valve replacement (TAVR) is a well-known adverse event for all interventional cardiologists. However, it has been understudied: only small observational research has been conducted, showing too wide incidence rates. This research included all patients who underwent TAVR in the USA between 2016 and 2018, totaling over 100,000 patients. All subjects...
Same Contrast Dose, Different Risk of Kidney Injury, Depending on Procedure
The risk of contrast induced kidney injury is significantly lower in patients receiving transcatheter aortic valve replacement (TAVR) compared against patients getting a coronary angiography or angioplasty. This is true even for valvular heart disease patients with higher risk profiles. Differences in contrast-induced acute kidney injury between TAVR or coronary patients had not been previously...
A New Molecule to Prevent Contrast-Induced Kidney Injury
Administrating Recombinant Human C1-Esterase-Inhibitor (rhC1INH) before coronary angiography might mitigate contrast induced kidney injury. In addition, it shows a favorable safety profile in populations with multiple comorbidities. The contrast material used in all our diagnostic tests and therapeutic procedures causes tubular cytotoxicity and ischemia/reperfusion injury. rhC1INH had been effective at mitigating this mechanism in experimental...
Trying to Reduce Post TAVR Kidney Injury
Acute kidney injury is a common complication after transcatheter aortic valve replacement (TAVR) and is associated to increased mortality both short and long-term. In patients undergoing percutaneous coronary intervention (PCI) forcing diuresis with controlled hydration has shown to reduce the incidence of acute kidney injury in nearly 50%. However, this has not been tested in...
Strategies to Reduce Acute Kidney Injury in Angioplasty
The title of this article leads us to think that we will find a list of things that we can do to reduce kidney injury. However, (unfortunately) sodium bicarbonate showed no benefit over saline and n-acetylcysteine showed no benefit over a placebo for the reduction of kidney damage after coronary angioplasty. Among the protective measures...
Contrast Induced Kidney Injury, Infamous Problem with No Magical Solutions
In patients at high risk of developing kidney complications undergoing angiography, we did not observe benefits when administering intravenous sodium bicarbonate vs. saline, or oral N-acetylcysteine vs. placebo, as to the prevention of death, dialysis or persistent deterioration of kidney function at 90 days, or the prevention of contrast induced kidney failure. Many small studies...