The Potential Role of Anesthesia Type in Acute Kidney Injury After TAVR

In their study, Özer Şensoy et al. evaluated the impact of acute kidney injury (AKI) on long-term mortality and major adverse cardiac events in diabetic patients undergoing transcatheter aortic valve replacement (TAVR). While the study addresses an important clinical issue, the potential influence of anesthesia type on AKI development and subsequent outcomes was not explored. Because local anesthesia and general anesthesia may differ in their effects on hemodynamic stability, vasoactive drug requirement, and renal perfusion, anesthesia strategy may represent a relevant confounding factor in the relationship between AKI and adverse outcomes after TAVR. Considering anesthesia type in subgroup or multivariable analyses could provide a more comprehensive understanding of the determinants of renal and cardiovascular outcomes in this setting.