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

Publication ,  Journal Article
Yalcin, YC; Muslem, R; Veen, KM; Soliman, OI; Hesselink, DA; Constantinescu, AA; Brugts, JJ; Manintveld, OC; Fudim, M; Russell, SD; Houston, BA ...
Published in: J Card Fail
April 2020

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.

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Published In

J Card Fail

DOI

EISSN

1532-8414

Publication Date

April 2020

Volume

26

Issue

4

Start / End Page

333 / 341

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Retrospective Studies
  • Renal Insufficiency, Chronic
  • Middle Aged
  • Male
  • Humans
  • Heart-Assist Devices
  • Heart Failure
  • Female
  • Cohort Studies
 

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Yalcin, Y. C., Muslem, R., Veen, K. M., Soliman, O. I., Hesselink, D. A., Constantinescu, A. A., … Caliskan, K. (2020). Impact of Continuous Flow Left Ventricular Assist Device Therapy on Chronic Kidney Disease: A Longitudinal Multicenter Study. J Card Fail, 26(4), 333–341. https://doi.org/10.1016/j.cardfail.2020.01.010
Yalcin, Yunus C., Rahatullah Muslem, Kevin M. Veen, Osama I. Soliman, Dennis A. Hesselink, Alina A. Constantinescu, Jasper J. Brugts, et al. “Impact of Continuous Flow Left Ventricular Assist Device Therapy on Chronic Kidney Disease: A Longitudinal Multicenter Study.J Card Fail 26, no. 4 (April 2020): 333–41. https://doi.org/10.1016/j.cardfail.2020.01.010.
Yalcin YC, Muslem R, Veen KM, Soliman OI, Hesselink DA, Constantinescu AA, et al. Impact of Continuous Flow Left Ventricular Assist Device Therapy on Chronic Kidney Disease: A Longitudinal Multicenter Study. J Card Fail. 2020 Apr;26(4):333–41.
Yalcin, Yunus C., et al. “Impact of Continuous Flow Left Ventricular Assist Device Therapy on Chronic Kidney Disease: A Longitudinal Multicenter Study.J Card Fail, vol. 26, no. 4, Apr. 2020, pp. 333–41. Pubmed, doi:10.1016/j.cardfail.2020.01.010.
Yalcin YC, Muslem R, Veen KM, Soliman OI, Hesselink DA, Constantinescu AA, Brugts JJ, Manintveld OC, Fudim M, Russell SD, Tomashitis B, Houston BA, Hsu S, Tedford RJ, Bogers AJJC, Caliskan K. Impact of Continuous Flow Left Ventricular Assist Device Therapy on Chronic Kidney Disease: A Longitudinal Multicenter Study. J Card Fail. 2020 Apr;26(4):333–341.
Journal cover image

Published In

J Card Fail

DOI

EISSN

1532-8414

Publication Date

April 2020

Volume

26

Issue

4

Start / End Page

333 / 341

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Retrospective Studies
  • Renal Insufficiency, Chronic
  • Middle Aged
  • Male
  • Humans
  • Heart-Assist Devices
  • Heart Failure
  • Female
  • Cohort Studies