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Sigala, Evangelia; Vlachopoulos, Charalambos; Triantafyllou, Konstantinos; Katsaros, Andreas; Koumallos, Nikolaos; Lozos, Vasilios; Baikoussis, Nikolaos; Kouerinis, Ilias; Giakis, Nikolaos; Michael, Demosthenous; Printzios, Dimitrios Terentes; Filis, Konstantinos; Tousoulis, Dimitrios
Artery research, 12/2019, Letnik: 25, Številka: Suppl 1Journal Article
Purpose/Background/Objectives Acute kidney injury (AKI) is a serious postoperative complication. Increased arterial stiffness has been shown to be an independent risk factor for cardiovascular events. Our aim was to investigate whether arterial stiffness is a predictor of AKI in patients following surgical aortic valve replacement (SAVR). Methods Eighty-four patients (mean age 72 ± 8 years, 34 females) with moderate to severe aortic stenosis undergoing SAVR were included. As indicators of arterial stiffness aortic hemodynamics, carotid-femoral pulse wave velocity (cfPWV) and brachial-ankle pulse wave velocity (baPWV) were assessed prior to surgery. Renal dysfunction was defined when eGFR was below 60 ml/min ( n = 28, 33%). AKI was defined using KDIQO criteria. Results Twelve patients (14%) developed AKI. There was no significant difference in aortic hemodynamics and cfPWV between the two groups. baPWV significantly correlated with AKI ( r = 0.313, p = 0.004). In logistic regression analysis, increase of baPWV per 1 Standard Deviation (Odds Ratio OR = 2.76, 95% Confidence intervals CI: 1.25–6.11, p = 0.012) and presence of renal dysfunction (OR = 14.93, 95% CI: 2.55–87.32, p = 0.003) were associated with higher risk for AKI even after adjustment for age, gender, systolic blood pressure and diabetes. baPWV was a stronger predictor of AKI than baseline creatinine (Area under the curve AUC 0.68, 95% CI: 0.52–0.84, p = 0.05 vs AUC 0.61, 95% CI: 0.46–0.77, p = 0.21; p < 0.05). Conclusion baPWV could be considered as a useful predictive biomarker for AKI after SAVR, especially in patients with renal dysfunction prior to surgery.
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