Related Experiment Video
Updated: Aug 27, 2025
08:39
A Murine Model of Hemodialysis Access-Related Hand Dysfunction
Published on: May 31, 2022
1.7K
Distinctive kidney function trajectories following left ventricular assist device implantation
Carl P Walther1, Julia S Benoit2, Harveen K Lamba3
1Department of Medicine, Baylor College of Medicine, Selzman Institute for Kidney Health, Section of Nephrology, Houston, Texas.
Summary
Distinct kidney function trajectories were identified in patients receiving a left ventricular assist device (LVAD). Some patients showed sustained improvement or worsening kidney function, indicating varied cardiorenal responses post-LVAD implantation.
Area of Science:
- Cardiology
- Nephrology
- Medical Devices
Background:
- Left ventricular assist device (LVAD) recipients often show initial kidney function improvement followed by decline.
- Individual variations in kidney function response after LVAD are not well understood.
Purpose of the Study:
- To identify distinct kidney function trajectories after LVAD implantation.
- To investigate clinical differences among identified kidney function groups.
Main Methods:
- Analysis of continuous flow LVAD implantations in US adults (2016-2017) from the INTERMACS registry.
- Application of latent class mixed models to estimate glomerular filtration rate (eGFR) trajectories from pre-implantation to 12 months.
- Investigation of clinical characteristics and outcomes across different eGFR trajectory groups.
Main Results:
- Five distinct eGFR trajectory groups were identified among 4,615 LVAD recipients.
- Two large groups mirrored previously reported trends (early rise, then decline/stabilization).
- Three novel groups emerged: sustained worsening (10.1%), sustained improvement (3.3%), and worsening with variation (1.7%), differing in baseline characteristics and outcomes.
Conclusions:
- Novel eGFR trajectories following LVAD implantation suggest distinct cardiorenal processes.
- Sustained improvement may relate to Type 1 cardiorenal syndrome.
- Worsening kidney function may be linked to parenchymal kidney disease.
Keywords:
advanced heart failurecardiorenalcontinuous-flow left ventricular assist devicekidney functionlatent class mixed modelstrajectoryMore Related Videos
Related Concept Videos
01:28Kidney Transplant I: Introduction
46
A kidney transplant is a surgical approach that involves replacing a non-functioning kidney with a healthy one from a donor. This procedure is often a treatment option for end-stage renal disease (ESRD) patients. The method requires careful recipient selection, including evaluating various medical and psychosocial factors. These criteria vary between transplant centers but generally include assessments of the patient's overall health, adherence to medical recommendations, and lifestyle...
46
01:29Acute Kidney Injury III: Clinical Manifestations
69
Acute Kidney Injury (AKI) progresses through distinct clinical phases: the oliguric, diuretic, and recovery phases, each marked by unique manifestations and challenges.Oliguric Phase:The oliguric phase is the initial stage of AKI, typically lasting 10 to 14 days. This phase is marked by a significant reduction in urine output, usually less than 400 mL per day, indicating decreased kidney function. Fluid retention is a prominent feature, leading to symptoms such as edema, hypertension, and...
69
01:29Cardiomyopathy V: Interprofessional Care
28
Managing cardiomyopathy involves addressing underlying or precipitating causes, treating heart failure with medications, and implementing dietary changes and a balanced exercise and rest regimen.Lifestyle ModificationsCardiomyopathy patients should adopt a low-sodium diet to reduce fluid retention and manage heart failure. A personalized exercise and rest plan helps maintain physical fitness without overstraining the heart. Avoiding alcohol and tobacco is essential to prevent further damage to...
28
01:16Kidney Transplant III: Nursing Management
71
Postoperative Nursing Management for Kidney Transplant PatientsPostoperative nursing management care includes monitoring the surgical site, encouraging early movement, and promoting lung health through breathing exercises. Nurses also administer prescribed medications like H2-blockers, such as famotidine, or proton pump inhibitors, like omeprazole, to help prevent gastrointestinal ulcers and bleeding. Fungal infections in the mouth and bladder can result from immunosuppressive and antibiotic...
71
01:30Acute Kidney Injury IV: Diagnostic Studies and Prevention
53
Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
53
01:22Acute Kidney Injury I: Introduction
60
Introduction:Acute Kidney Injury (AKI) describes a swift decrease in kidney function occurring over hours to days, characterized by the kidneys' failure to remove waste products from the bloodstream. This leads to dangerous complications like metabolic acidosis, fluid overload, and electrolyte imbalances, such as hyperkalemia, which can cause life-threatening arrhythmias. AKI is common in both hospital and outpatient settings, often triggered by dehydration, sepsis, or exposure to nephrotoxic...
60