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Assessment of Vascular Function in Patients With Chronic Kidney Disease
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Published on: June 16, 2014

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Impact of Continuous Flow Left Ventricular Assist Device Therapy on Chronic Kidney Disease: A Longitudinal

Yunus C Yalcin1, Rahatullah Muslem1, Kevin M Veen2

  • 1Thoraxcenter, Unit Heart Failure, Transplantation and Mechanical Circulatory Support, Department of Cardiology, University Medical Center Rotterdam, Rotterdam, the Netherlands; Department of Cardiothoracic Surgery, University Medical Center Rotterdam, Rotterdam, the Netherlands.

Journal of Cardiac Failure
|January 26, 2020
PubMed

Insights

Left ventricular assist device (LVAD) implantation initially improves chronic kidney disease (CKD) in patients. However, kidney function eventually returns to baseline, though early improvement correlates with better survival rates.

Area of Science:

  • Cardiology
  • Nephrology
  • Medical Devices

Background:

  • Many patients with chronic kidney disease (CKD) undergo left ventricular assist device (LVAD) implantation.
  • The impact of LVAD support on CKD progression requires investigation.

Purpose of the Study:

  • To investigate the effect of LVAD support on patients with pre-existing chronic kidney disease (CKD).

Main Methods:

  • A retrospective multicenter cohort study involving 400 patients implanted with LVADs (HeartMate II, HeartMate 3, HeartWare).
  • Patients were stratified by CKD stage and followed for 2 years with serum creatinine measurements.
  • Analysis included assessment of kidney function changes and survival rates.

Main Results:

  • Pre-implantation CKD stages ranged from 1 to 5.
  • LVAD implantation initially improved kidney function across all CKD stages.
  • Estimated glomerular filtration rates regressed to baseline values post-improvement.
  • Early renal function improvement was associated with younger patients, worse preoperative condition, and higher survival rates (69% vs. 56%).

Conclusions:

  • Renal function after LVAD implantation shows an initial improvement, followed by a steady state, and subsequent deterioration.
  • Patients exhibiting early renal function improvement, despite worse preoperative condition, demonstrated significantly higher 2-year survival rates.
Abstract

Keywords:
Left ventricular assist devicechronic kidney diseaseend-stage heart failurerenal improvement

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