New risk score helps cardiologists predict when TAVR patients will need dialysis

The team developed the TRITAVIpre score, which focuses on pretreatment variables associated with increased risk of RRT. Next, he added a procedural variable to the equation for another risk score, TRITAVIpost.

According to the TRITAVIpre risk score, men were associated with a higher risk of requiring dialysis than women.Diabetes, history of coronary artery bypass grafting, anemia, non-femoral access, and a creatinine clearance of less than 30 mL/min per square meter² It was also associated with increased risk.

Meanwhile, the TRITAVIpost risk score found that the amount of contrast medium, the need for blood transfusions, and major vascular complications all increased the risk of patients requiring dialysis after TAVR.

Even with a low TRITAVIpre score, only 0.3% of patients required dialysis after TAVR. In patients with high TRITAVIpre scores, that number increased to 3.9%. A similar trend was seen in her TRITAVIpost risk score. Dialysis was required after TAVR in 0.1% of patients with low scores and 6.2% of patients with high scores.

Finally, the authors applied both risk scores to all patients in the validation cohort. Each score allowed us to identify patients who may be at high risk of requiring dialysis after TAVR. The C-statistic was 0.80 for TRITAVIpre and 0.81 for TRITAVIpost.

“Our study was able to identify factors associated with the need for RRT in a large contemporary patient population undergoing TAVR,” the authors wrote. “A simple preprocedural clinical score can help assess the risk of this serious complication associated with high mortality.”

Further research is still needed to learn more about the potential impact of this risk score on patient care, the research group added.

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