SYSTEMATIC REVIEW article
Front. Cardiovasc. Med.
Sec. Heart Valve Disease
Risk Factors for Acute Kidney Injury Following Transcatheter Aortic Valve Replacement: A Systematic Review and Meta-Analysis
Nan Jiang 1
Xue Liu 2
Jiwei Huang 1
Yi Jiang 1
Dan Li 1
1. The First People's Hospital of Zigong, Zigong, China
2. the Second People's Hospital of Yibin, Yibin, China
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Abstract
Objective: To delineate risk factors for acute kidney injury (AKI) after transcatheter aortic valve replacement (TAVR) via a systematic review and meta-analysis. Methods: PubMed, Embase, the Cochrane Library, and Web of Science were searched through February 2025 for case-control studies reporting post-TAVR AKI. Two reviewers independently performed study selection, data extraction, and bias assessment. Pooled analyses were conducted with Stata 15.0. Results: Thirty-four studies (10,353 patients) met the inclusion criteria; 2,250 patients (21.7 %) developed AKI. Univariable meta-analysis implicated multiple comorbid, hemodynamic, and procedural factors (e.g., hypertension, diabetes, coronary and peripheral vascular disease, porcelain aorta, prior PCI, atrial fibrillation, chronic kidney disease (CKD), advanced NYHA class, left ventricular ejection fraction (LVEF) < 40 %, anemia, diuretic use, transapical/transaortic access, general anesthesia, rapid pacing, bleeding or vascular complications, transfusion, and peri-procedural myocardial infarction or stroke; all p < 0.05). Multivariable pooling isolated eight independent predictors: hypertension (OR 2.87), coronary artery disease (1.46), peripheral vascular disease (1.71), prior stroke (1.61), CKD (3.27), elevated serum creatinine (2.80), higher STS score (1.06 per point), and transapical access (3.45). Publication bias was not detected. Conclusions: Post-TAVR AKI is chiefly driven by cardiovascular comorbidity and renal impairment, with hypertension, coronary and peripheral vascular disease, prior stroke, CKD, elevated creatinine, high STS score, and transapical access displaying the strongest, independent associations. Awareness of these factors may facilitate peri-procedural risk stratification and targeted renal-protective strategies.
Summary
Keywords
AKI, Meta-analysis, Risk factors, Systematic review, TAVR
Received
13 August 2025
Accepted
09 February 2026
Copyright
© 2026 Jiang, Liu, Huang, Jiang and Li. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Nan Jiang
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