Urinary Cell Cycle Arrest Biomarker Nephrocheck to Predict Acute Kidney Injury in Patients after Transfemoral TAVR Procedure

Objectives: Acute kidney injury (AKI) after TAVR procedure carries a high-risk factor especially when superimposed on chronic kidney disease, which is a frequent comorbidity in the elderly with severe aortic stenosis. The AKI prevalence in TAVR patients vary between 3.4 and 57% until 21% requiring renal replacement therapy.

The aim of this study was to test the diagnostic accuracy of urinary Nephrocheck® for prognostic value for therapy and predict occurrence of AKI responding patients.

Methods: A total of 34 consecutive TAVR patients (53% men, mean age: 84 years (range: 64–89) were included. The new urinary cell cycle arrest biomarker was measured as well as serum creatinine (S-Crea), calculated GFR. The marker was analyzed 4 hours postinterventional in urine samples applying as recommended a cut-off of Nephrocheck at 0.3 ng/dL.

Result: One patient exceeded the Nephrocheck value cut-off of 0.3 ng/dL, 97% stayed under. The GFR/S-Crea kinetics during hospitalization showed no incidences of AKI (before OP 79/0.4 mg/dL vs. 1 pod 85/0.7 mg/dL vs. 2 pod 83/0.7 mg/dL vs. before discharge 47/1.4 mg/dL) with sufficient urine production. Despite this fact no dialysis had to be performed, two deaths occurred of general weakness shortly after procedure.

Conclusion: A new AKI marker has been tested in a small average cardiac patients without long cardiac arrest. Nearly all patients developed no acute kidney injury (KDIGO stage) on the bases of sufficiency nephroprotect therapy postinterventional.

The results of this study suggest that Nephrocheck is not suitable for diagnostic of AKI in TAVR cohort with short time of low output. But there might be evidence for prognostic value of Nephrocheck in regard to high risk patients with preexisting kidney damage prior to TAVR .

No conflict of interest has been declared by the author(s).

Publication History

Article published online:
19 February 2021