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Closed-loop system reduces kidney injury rate in CV interventional procedures
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In moderate- to high-risk patients with chronic kidney disease undergoing cardiac interventional procedures, a closed-loop system significantly reduced rates of contrast-induced acute kidney injury and was linked to decreased rates of mortality, dialysis and MACCE vs. standard intravascular volume expansion, according to data published in the Journal of Interventional Cardiology.
Anand Prasad, MD, FACC, FASCI, RPVI, from the department of medicine and division of cardiology at the University of Texas Health Science Center at San Antonio, and colleagues conducted a meta-analysis of 10 existing studies comparing the use of the RenalGuard (RenalGuard Solutions) novel closed- loop system with standard care.
Of the 10 eligible studies, four were randomized controlled trials.
The meta-analysis had an aggregate sample size of 1,585 patients. Of these patients, 698 were enrolled in the randomized controlled trials and 887 were in registries.
The primary outcomes of the meta-analysis included contrast-induced acute kidney injury (CI-AKI) and RR.
Secondary outcomes were mortality, dialysis and MACCE.
The researchers found that the use of the RenalGuard system was linked to significant reductions in CI-AKI vs. standard volume expansion (RR = 0.3; 95% CI, 0.18-0.5).
According to the study, the rate of CI-AKI in the RenalGuard group was 7.7% vs. 23.6% in the control group (P < .01).
There was an observed reduction in mortality (RR = 0.43; 95% CI, 0.18-0.99), dialysis (RR = 0.2; 95% CI, 0.06-0.61) and MACCE (RR = 0.42; 95% CI, 0.27-0.65) rates for those included in the RenalGuard group vs. those in the control group.
“Kidney injury following [transcatheter aortic valve replacement] is one of the strongest predictors of long-term mortality postprocedure,” Andrew Halpert, chief technology officer for RenalGuard Solutions, said in a press release. “We expect these findings to continue to drive adoption of RenalGuard Therapy in the growing TAVR market, as well as all of the other applications where RenalGuard has been found to reduce incidence of CI-AKI.” – by Dave Quaile
Disclosures: Halpert reports he is an employee of RenalGuard Solutions Inc. Prasad reports he is a consultant for GE and Osprey Medical, a speaker for Abiomed, AstraZeneca and Gilead, and receives research funding from ACIST Medical and Medtronic.
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