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

Yunus C. Yalcin, Rahatullah Muslem, Kevin M. Veen, Osama I. Soliman, Dennis A. Hesselink, Alina A. Constantinescu, Jasper J. Brugts, Olivier C. Manintveld, Marat Fudim, Stuart D. Russell, Brett Tomashitis, Brian A. Houston, Steven Hsu, Ryan J. Tedford, Ad J.J.C. Bogers, Kadir Caliskan

Research output: Contribution to journalArticlepeer-review

5 Scopus citations

Abstract

Background: Many patients undergoing durable left ventricular assist device (LVAD) implantation suffer from chronic kidney disease (CKD). Therefore, we investigated the effect of LVAD support on CKD. Methods: A retrospective multicenter cohort study, including all patients undergoing LVAD (HeartMate II (n = 330), HeartMate 3 (n = 22) and HeartWare (n = 48) implantation. In total, 227 (56.8%) patients were implanted as bridge-to-transplantation; 154 (38.5%) as destination therapy; and 19 (4.7%) as bridge-to-decision. Serum creatinine measurements were collected over a 2-year follow-up period. Patients were stratified based on CKD stage. Results: Overall, 400 patients (mean age 53 ± 14 years, 75% male) were included: 186 (46.5%) patients had CKD stage 1 or 2; 93 (23.3%) had CKD stage 3a; 82 (20.5%) had CKD stage 3b; and 39 (9.8%) had CKD stage 4 or 5 prior to LVAD implantation. During a median follow-up of 179 days (IQR 28–627), 32,629 creatinine measurements were available. Improvement of kidney function was noticed in every preoperative CKD-stage group. Following this improvement, estimated glomerular filtration rates regressed to baseline values for all CKD stages. Patients showing early renal function improvement were younger and in worse preoperative condition. Moreover, survival rates were higher in patients showing early improvement (69% vs 56%, log-rank P = 0. 013). Conclusions: Renal function following LVAD implantation is characterized by improvement, steady state and subsequent deterioration. Patients who showed early renal function improvement were in worse preoperative condition, however, and had higher survival rates at 2 years of follow-up.

Original languageEnglish (US)
Pages (from-to)333-341
Number of pages9
JournalJournal of cardiac failure
Volume26
Issue number4
DOIs
StatePublished - Apr 2020

Keywords

  • Left ventricular assist device
  • chronic kidney disease
  • end-stage heart failure
  • renal improvement

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Fingerprint

Dive into the research topics of 'Impact of Continuous Flow Left Ventricular Assist Device Therapy on Chronic Kidney Disease: A Longitudinal Multicenter Study'. Together they form a unique fingerprint.

Cite this