Zeynep Esra Güner, Rıdvan Bolataslan, Regayip Zehir
Interventional Cardiology Perspectives - 2025;1(3):104-111
Background: Acute kidney injury (AKI) following transcatheter aortic valve replacement (TAVR) is a common and serious complication that adversely affects patient prognosis and in-hospital mortality rates. Identifying patients at a higher risk before the procedure remains a clinical priority. Aim: This study aimed to investigate the relationship between AKI and the Naples prognostic score (NPS) in patients undergoing TAVR. Study Design: This was a retrospective, single-center cohort study. Methods: A total of 203 patients who underwent TAVR between 2019 and 2024 were retrospectively evaluated in this study. Patients were divided into two groups according to the presence or absence of AKI. Logistic regression analysis was used to determine the independent predictors of AKI, and receiver operating characteristic (ROC) curve analysis was performed to assess the predictive value of NPS. Results: AKI occurred in 39 of the 203 patients (19.2%). A high NPS was significantly more frequent in the AKI group than in the non-AKI group (61.5% vs. 39.6%, p=0.013). Multivariate analysis identified the following as independent predictors of AKI: high NPS [odds ratio (OR): 3.41; 95% confidence interval (CI): 1.08-10.78; p=0.037], lower estimated glomerular filtration rate (OR: 0.87; 95% CI: 0.83-0.92; p<0.001), elevated C-reactive protein (OR: 2.35; 95% CI: 1.49-3.72; p<0.001), higher contrast volume (OR: 1.07; 95% CI: 1.03-1.11; p=0.001), lower ejection fraction (OR: 0.94; 95% CI: 0.90-0.98; p=0.004), and elevated glycated hemoglobin (OR: 2.12; 95% CI: 1.13-4.00; p=0.020). ROC curve analysis showed that an NPS cut-off value of 2.5 predicted AKI with 61.5% sensitivity and 60.4% specificity (area under the curve: 0.635; 95% CI: 0.544-0.726; p=0.009). Conclusion: The NPS may serve as a practical and easily applicable tool for identifying patients at increased risk of AKI following TAVR. Incorporating NPS into preprocedural risk assessment could improve patient stratification and guide preventive management.
