Acute kidney injury after MitraClip implantation in patients with severe mitral regurgitation

Ivaylo Tonchev, Dan Heberman, Alona Peretz, Anna Turyan Medvedovsky, Israel Gotsman, Yonatan Rashi, Lion Poles, Sorel Goland, Gidon Y. Perlman, Haim D. Danenberg, Ronen Beeri, Mony Shuvy*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

9 Scopus citations

Abstract

Introduction: Percutaneous mitral valve repair (PMVR), such as MitraClip, is performed on high-risk patients and involves hemodynamic alternations that may cause acute kidney injury (AKI). We aimed to evaluate the incidence of AKI, predictors for developing AKI and the correlation with mortality after MitraClip. Methods: We performed a retrospective analysis of collected data from patients who underwent PMVR in two tertiary medical centers in Israel to identify factors associated with AKI. Results: The study population included 163 patients. The median age was 77 years; 60.7% of patients were male. The median eGFR significantly decreased post-procedure from 49 (35–72) to 47.8 (31–65.5) ml/min/1.73 m2 (p <.001). Forty-seven patients (29%) developed AKI. None of the patients who developed AKI required hemodialysis. Predictors of AKI included: baseline eGFR ≤30 ml/min/1.73 m2, severity of residual MR, TMPG>5 mmHg, diuretic use, and re-do procedures. Among the patients who developed AKI there was an improvement in kidney function during follow-up, and creatinine levels significantly decreased from a peak mean creatinine of 179.5 (143–252) mmol/l to 136 (92–174) mmol/l (p <.001). However, 19% (9 out of 47) of patients experienced partial recovery and their creatinine level, when compared to their baseline, remained elevated. One-year survival showed a trend for increased mortality among patients who developed AKI (86.2% vs. 80.9%, p =.4), and patients who developed AKI that persisted had increased 1-year mortality compared with patients that had recovered their kidney function (86.8% vs. 55.6%, p =.01). Conclusion: The incidence of AKI after MitraClip is high. AKI is reversible in most patients; however, the persistence of kidney injury is associated with increased 1-year mortality.

Original languageAmerican English
Pages (from-to)E868-E874
JournalCatheterization and Cardiovascular Interventions
Volume97
Issue number6
DOIs
StatePublished - 1 May 2021
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2020 Wiley Periodicals LLC.

Keywords

  • MitraClip
  • acute kidney injury
  • mitral regurgitation

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