ABC | Volume 113, Nº6, December 2019

Original Article Calça et al. Aortic valve repair and kidney function Arq Bras Cardiol. 2019; 113(6):1104-1111 Figure 2 – Comparison of eGFR between groups after the TAVI procedure. A: Group 1; B: Group 2; C: Group 3. eGFR: estimated glomerular filtration rate; TAVI: transcatheter aortic valve implantation. 90 80 70 60 50 40 30 20 10 0 79.9 65.6 p = 0.002 p < 0.001 p = 0.849 63.4 45.5 50.1 p = 0.079 p = 0.002 p = 0.779 52.6 24.2 34.9 p = 0.119 p = 0.037 p = 0.631 38.4 Pré-TAVI One month after TAVI One year after TAVI Pré-TAVI One month after TAVI One year after TAVI Group 1 Group 2 Group 3 A B C TFGe (mL/min/1.73 m 2 ) 40 45 30 35 20 25 10 15 0 5 TFGe (mL/min/1.73 m 2 ) 50 48 40 46 44 54 42 52 TFGe (mL/min/1.73 m 2 ) Pré-TAVI One month after TAVI One year after TAVI Regarding the administration of contrast, the three groups showed no differences regarding the volume received; thus, volume was not a predictor of worsening in eGFR after one month and one year. The predictive value of contrast volume for kidney dysfunction after TAVI is controversial: 15,22,23 in a meta-analysis with over 3,800 patients post-TAVI, higher contrast use was not clearly associated with a greater risk of AKI. 24 However, we found a difference in the type of contrast administered in Group 1: most patients with CKD G1-2 at baseline received Iomeron® and this iodine contrast was a predictor of worsening in eGFR. Iodine contrast is divided into three groups according to their osmolarity. Iomeron® is a low-osmolar contrast characterized by values within 300–900 mOsm/kg H 2 O. 25 Visipaque® is iso-osmolar, having an osmolarity level similar to that of blood (290 mOsm/kg H 2 O) 1108