The choice of the type of CM to be used for the procedure was institution- and physician-dependent; the CM were: (1) iodixanol, iodinated non-ionic iso-osmolar, dimeric, (2) iopromide, (3) iobitridol, (4) iohexol and (5) iomeprol, all iodinated non-ionic low-osmolar, monomeric. According to CM osmolality, the population was retrospectively divided in 2 groups: IOCM group (n = 370) and LOCM group (n = 327).

The amount of CM was recorded during all TAVI procedures. According to the previous investigations, the CM volume x SCr/body weight, CM volume/CrCl and CM volume/eGFR ratios were used to evaluate the degree of CM dose in individual patients [3], [4], [5].

Isotope diluition mass spectroscopy was used to measure SCr level at the admission (at least 1 day before the procedure), on the procedure day (after continuing the overnight hydration), and then daily until the discharge. Baseline SCr was defined as the SCr measured before and closest to the time of TAVI procedure. If there was >1 measurement post-TAVI available, the greater SCr value within 48 h was included in the analysis. Via a Foley catheter or an external collection device, urine output (UO) was evaluated through at least 72 h after TAVI or until hospital discharge if that occurred earlier than 72 h after TAVI. eGFR was calculated with the simplified Modification of Diet in Renal Disease formula [6], while CrCl rate using Cockcroft-Gault formula. For the present analysis, CKD was defined as baseline eGFR of <60 mL/min/1.73 m2.

AKI was defined as stage 1, 2 or 3 by AKI Network from the SCr- and UO-based criteria; according to such system [7]:

Patients receiving renal replacement therapy were considered to meet stage 3 criteria irrespective of other criteria. The indications for renal replacement therapy included fluid overload with heart failure, hyperkalemia, hypercalcemia, metabolic acidosis, uremic symptoms, and oliguria or anuria (UO <200 mL/12 h or UO <50 mL/12 h, respectively).

Preprocedural anemia was defined by the World Health Organization definition of anemia: hemoglobin <12 g/dL for women and <13 g/dL for men [8]. Nadir hemoglobin was defined as the lowest hemoglobin measured after TAVI until discharge.

All other complications as well as device success and early safety were defined according to the VARC-2 standardized criteria [9].

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