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  • Editor in Chief: Prof. Andrea Remuzzi
  • Frequency: monthly
  • Current issue: Vol. 37 issue 8 , 2014 (August)

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Vol. 37 Issue 5 (May 2014)

Evolution of renal function after partial and full mechanical support for chronic heart failure

Evolution of renal function after partial and full mechanical support for chronic heart failure

Int J Artif Organs 2014; 37(5): 364 - 370

Article Type: ORIGINAL ARTICLE

Article Subject: Cardiac assist and artificial heart

DOI:10.5301/ijao.5000326

Authors

Steven Jacobs, Walter Droogne, Valerie Waelbers, Klaartje Van den Bossche, Hilde Bollen, Jef Geens, Filip Rega, Daniel Burkhoff, Bart Meyns

Corresponding author

  • Steven Jacobs
  • UZ Leuven
  • Herestraat 49
  • B - 3000 Leuven, Belgium

Abstract

Purpose

Recently a minimal invasive, partial support continuous flow left ventricular assist device (LVAD) became available for treatment of chronic heart failure. The aim of this study was to analyze whether partial support is capable of improving kidney function in end-stage heart failure.

Methods

We performed a single-center retrospective analysis of patients how received a full (n = 43) or partial support LVAD (n = 18) between 2007 and 2013. Patients on dialysis or in INTERMACS class I were excluded. Renal function was assessed until 3 months after the implantation. A calculated GFR less than 60 m/min was considered to be renal failure.

Results

Creatinine level after LVAD implant decreased 23% in patients on full support (1.3 ± 0.4 mg/dl vs. 1.0 ± 0.3 mg/dl; p<0.001) and 24% in patients on partial support (1.6 ± 0.6 mg/dl vs. 1.2 ± 0.4 mg/dl; p = 0.17) within 3 months. In each group patients with a preoperative GFR less than 60 ml/min were selected. In this subgroup there was a 35% decrease in creatinine levels for patients on full support (1.7 ± 0.4 mg/dl vs. 1.1 ± 0.5 mg/dl; p<0.01) and a 32% decrease in patients on partial support (2 ± 0.4 mg/dl vs. 1.4 ± 0.3 mg/dl; p<0.05) at 3 months.

Conclusions

We observed a significant improvement in renal function in patients supported by full or partial support devices, even if the preoperative renal function was severly impaired. The use of diuretics decreased in both groups. In chronic heart failure patients with impaired renal function, partial support is sufficient to improve renal function significantly.

Article History

Disclosures

Financial Support: None.
Conflict of Interest: Bart Meyns receives research grants from CircuLite Inc., Saddlebrook, NJ, USA; Daniel Burkhoff is an employee of CircuLite Inc., Saddlebrook, NJ, USA.

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Authors

  • Address for correspondence:
  • UZ Leuven
  • Herestraat 49
  • steven.jacobs@med.kuleuven.be

Affiliations

  • Cardiac Surgery, Catholic University Leuven, Leuven - Belgium
  • Cardiology, Catholic University Leuven, Leuven - Belgium
  • Columbia University, New York, New York - USA
  • CircuLite, Inc., Saddle Brook, New Jersey - USA

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