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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 and Kenar D. Jhaveri
CJASN February 2018, 13 (2) 348-355; DOI: https://doi.org/10.2215/CJN.04670417
Daniel W. Ross
1Division of Kidney Diseases and Hypertension, Department of Medicine,
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Gerin R. Stevens
2Department of Cardiology, and
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Rimda Wanchoo
1Division of Kidney Diseases and Hypertension, Department of Medicine,
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David T. Majure
2Department of Cardiology, and
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Sandeep Jauhar
2Department of Cardiology, and
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Harold A. Fernandez
3Department of Cardiothoracic Surgery, Hofstra Northwell School of Medicine, Northwell Health, North Shore University Hospital, Manhasset, New York
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Massini Merzkani
1Division of Kidney Diseases and Hypertension, Department of Medicine,
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Kenar D. Jhaveri
1Division of Kidney Diseases and Hypertension, Department of Medicine,
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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.

  • LVAD
  • cardiovascular disease
  • cardiorenal
  • congestive heart failure
  • Cardio-Renal Syndrome
  • glomerular filtration rate
  • Heart-Assist Devices
  • Incidence
  • Acute Kidney Injury
  • Renal Replacement Therapy
  • Renal Insufficiency
  • Chronic
  • kidney
  • Heart Transplantation
  • Humans
  • Copyright © 2018 by the American Society of Nephrology
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Clinical Journal of the American Society of Nephrology: 13 (2)
Clinical Journal of the American Society of Nephrology
Vol. 13, Issue 2
February 07, 2018
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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
CJASN Feb 2018, 13 (2) 348-355; DOI: 10.2215/CJN.04670417

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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
CJASN Feb 2018, 13 (2) 348-355; DOI: 10.2215/CJN.04670417
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  • Article
    • Abstract
    • Introduction
    • The Basics of LVADs
    • AKI and Patient Outcomes in the Postoperative Period
    • Early and Late Changes in Kidney Function with LVAD Implantation
    • Lessons Learned about the Cardiorenal Syndrome from the LVAD Experience
    • Dialysis in Patients with LVADs
    • Conclusion
    • Disclosures
    • Acknowledgments
    • Footnotes
    • References
  • Figures & Data Supps
  • Info & Metrics
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More in this TOC Section

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  • Decision Algorithm for Prescribing SGLT2 Inhibitors and GLP-1 Receptor Agonists for Diabetic Kidney Disease
  • Cuffless Blood Pressure Monitoring
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Cited By...

  • Implantable Ventricular Assist Device Use and Outcomes in People With End-Stage Renal Disease
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Keywords

  • LVAD
  • cardiovascular disease
  • cardiorenal
  • congestive heart failure
  • Cardio-Renal Syndrome
  • glomerular filtration rate
  • Heart-Assist Devices
  • Incidence
  • acute kidney injury
  • Renal Replacement Therapy
  • renal insufficiency
  • chronic
  • kidney
  • Heart Transplantation
  • Humans

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