Acute kidney injury and 1-year mortality after left ventricular assist device implantation

Rahatullah Muslem, Kadir Caliskan, Sakir Akin, Kavita Sharma, Nisha A. Gilotra, Alina A. Constantinescu, Brian Houston, Glenn Whitman, Ryan Tedford, Dennis A. Hesselink, Ad J.J.C. Bogers, Stuart Russell, Olivier C. Manintveld

Research output: Contribution to journalArticlepeer-review

17 Scopus citations


Background Data on the consequences of acute kidney injury (AKI) after continuous-flow left ventricle assist device (LVAD) implantation are scarce and inconsistent. In this study, we evaluated the incidence, predictors and the impact of AKI on mortality and renal function in the first year after LVAD implantation. Methods A retrospective, multicenter cohort study was conducted, including all patients (age ≥18 years) undergoing LVAD implantation (91% with a HeartMate II device and 9% with a HeartWare device). The definition proposed by the Kidney Disease Improving Global Outcome (KDIGO) criteria was used to define AKI. Results Overall, 241 patients (mean age 52.4 ± 12.9 years, 76% males) were included in the study. AKI criteria were met in 169 (70%) patients, of whom 109 (45%) were in AKI Stage I, 22 (9%) in Stage II and 38 (16%) in Stage III. Two factors, the need for pre-operative inotropic support and pre-existent chronic kidney disease Stage ≤II (estimated glomerular filtration rate [eGFR] <30 ml/min/1.73 m2), were independently associated with the development of AKI and the severity of AKI stages. One-year mortality rates in patients without AKI and AKI Stages I, II and III were 18.7%, 26.4%, 23%, and 51%, respectively (log rank, p = 0.001). In the multivariable analysis, AKI Stage ≥II was independently associated with mortality (hazard ratio 2.2 [95% confidence interval 1.1 to 4.5], p = 0.027) and worse renal function (β = –7.4 [95% confidence interval –12.6 to –2.1], p < 0.01) at 1 year. Conclusion AKI is highly frequent after LVAD implantation. More severe AKI stages are associated with higher mortality rates and impaired renal function at 1 year after LVAD implantation.

Original languageEnglish (US)
Pages (from-to)116-123
Number of pages8
JournalJournal of Heart and Lung Transplantation
Issue number1
StatePublished - Jan 2018


  • heart failure
  • left ventricular assist device
  • mechanical circulatory support
  • renal insufficiency
  • renal replacement therapy

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine
  • Transplantation


Dive into the research topics of 'Acute kidney injury and 1-year mortality after left ventricular assist device implantation'. Together they form a unique fingerprint.

Cite this