TY - JOUR
T1 - Left ventricular assist devices and the kidney
AU - Ross, Daniel W.
AU - Stevens, Gerin R.
AU - Wanchoo, Rimda
AU - Majure, David T.
AU - Jauhar, Sandeep
AU - Fernandez, Harold A.
AU - Merzkani, Massini
AU - Jhaveri, Kenar D.
N1 - Publisher Copyright:
© 2018 by the American Society of Nephrology.
Copyright:
Copyright 2019 Elsevier B.V., All rights reserved.
PY - 2018/2/7
Y1 - 2018/2/7
N2 - Left ventricular assist devices (LVADs) are common and implantation carries risk of AKI. LVADs are used as a bridge to heart transplantation or as destination therapy. Patients with refractory heart failure that develop chronic cardiorenal syndrome and CKD often improve after LVAD placement. Nevertheless, reversibility of CKD is hard to predict. After LVAD placement, significant GFR increases may be followed by a late return to near baseline GFR levels, and in some patients, a decline in GFR. In this review, we discuss changes in GFR after LVAD placement, the incidence of AKI and associated mortality after LVAD placement, the management of AKI requiring RRT, and lastly, we review salient features about cardiorenal syndrome learned from the LVAD experience. In light of the growing number of patients using LVADs as a destination therapy, it is important to understand the effect of these devices on the kidney. Additional research and long-term data are required to better understand the relationship between the LVAD and the kidney.
AB - Left ventricular assist devices (LVADs) are common and implantation carries risk of AKI. LVADs are used as a bridge to heart transplantation or as destination therapy. Patients with refractory heart failure that develop chronic cardiorenal syndrome and CKD often improve after LVAD placement. Nevertheless, reversibility of CKD is hard to predict. After LVAD placement, significant GFR increases may be followed by a late return to near baseline GFR levels, and in some patients, a decline in GFR. In this review, we discuss changes in GFR after LVAD placement, the incidence of AKI and associated mortality after LVAD placement, the management of AKI requiring RRT, and lastly, we review salient features about cardiorenal syndrome learned from the LVAD experience. In light of the growing number of patients using LVADs as a destination therapy, it is important to understand the effect of these devices on the kidney. Additional research and long-term data are required to better understand the relationship between the LVAD and the kidney.
UR - http://www.scopus.com/inward/record.url?scp=85041707621&partnerID=8YFLogxK
U2 - 10.2215/CJN.04670417
DO - 10.2215/CJN.04670417
M3 - Review article
C2 - 29070522
AN - SCOPUS:85041707621
VL - 13
SP - 348
EP - 355
JO - Clinical Journal of the American Society of Nephrology
JF - Clinical Journal of the American Society of Nephrology
SN - 1555-9041
IS - 2
ER -