Evolution of renal function after partial and full mechanical support for chronic heart failure

Area of Science:

• Cardiology
• Nephrology
• Medical Devices

Background:

• Chronic heart failure (CHF) often leads to impaired kidney function.
• Left ventricular assist devices (LVADs) are used to treat end-stage heart failure.
• Minimal invasive, partial support continuous flow LVADs are a recent advancement.

Purpose of the Study:

• To evaluate the efficacy of partial support LVADs in improving renal function in patients with end-stage heart failure.
• To compare renal function outcomes between full support and partial support LVADs.

Main Methods:

• Single-center retrospective analysis of patients receiving full (n=43) or partial support (n=18) LVADs between 2007-2013.
• Exclusion of patients on dialysis or in INTERMACS class I.
• Assessment of renal function via creatinine levels and calculated GFR up to 3 months post-implantation; renal failure defined as GFR < 60 ml/min.

Main Results:

• Creatinine levels decreased by 23% in full support and 24% in partial support groups within 3 months.
• In patients with preoperative GFR < 60 ml/min, creatinine decreased by 35% (full support) and 32% (partial support) at 3 months.
• Diuretic use decreased in both support groups.

Conclusions:

• Both full and partial support LVADs significantly improve renal function, even in patients with severely impaired preoperative renal function.
• Partial support LVADs are sufficient to achieve significant renal function improvement in CHF patients with impaired renal function.
• LVAD implantation can positively impact renal outcomes in heart failure patients.