Left ventricular assist devices and the kidney

Daniel W. Ross, Gerin R. Stevens, Rimda Wanchoo, David T. Majure, Sandeep Jauhar, Harold A. Fernandez, Massini Merzkani, Kenar D. Jhaveri

Research output: Contribution to journalReview articlepeer-review

14 Scopus citations

Abstract

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.

Original languageEnglish
Pages (from-to)348-355
Number of pages8
JournalClinical Journal of the American Society of Nephrology
Volume13
Issue number2
DOIs
StatePublished - Feb 7 2018
Externally publishedYes

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