Worsening Renal Function in Cardiac Mechanical Support
| Autor: | Aaron Guo, Mohamed H. Derbala, Bryan Lee, Daniel Pinkhas, Brent C. Lampert, Julie Tsay, Joel Ferrall, Sakima A. Smith, Bryan A. Whitson, Sitaramesh Emani |
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| Rok vydání: | 2018 |
| Předmět: |
Pulmonary and Respiratory Medicine
Right heart catheterization Male medicine.medical_specialty medicine.medical_treatment Renal function 030204 cardiovascular system & hematology Risk Assessment 03 medical and health sciences 0302 clinical medicine Venous congestion Risk Factors Internal medicine medicine Humans 030212 general & internal medicine Renal Insufficiency Lead (electronics) Retrospective Studies Heart Failure business.industry Incidence Central venous pressure Middle Aged medicine.disease United States Single centre Heart failure Ventricular assist device Cardiology Female Heart-Assist Devices Cardiology and Cardiovascular Medicine business Follow-Up Studies Glomerular Filtration Rate |
| Zdroj: | Heart, lungcirculation. 29(8) |
| ISSN: | 1444-2892 |
| Popis: | Background Venous congestion in heart failure (HF) may lead to worsening renal failure (WRF). We hypothesised that WRF in patients hospitalised for left ventricular assist device (LVAD) implantation is associated with increased 1-year mortality. There is limited data regarding WRF in HF patients with mechanical support. The objective of this paper is to determine whether WRF in HF patients hospitalised for LVAD implantation is associated with increased 1-year mortality and to identify risk factors for WRF. Methods We performed a single centre retrospective chart analysis of 162 patients who received an LVAD between August 2006 and December 2014 with pre-LVAD right heart catheterisation data. We stratified patients to those who demonstrated WRF and the use of haemodialysis (HD) or ultrafiltration (UF). Results Patients with a higher central venous pressure (CVP) >16 mmHg (17–24 mmHg range) developed WRF (29.7% vs. 14.1%, p=0.019). A CVP ≥16 and glomerular filtration rate (GFR) 16 increased the odds of requiring HD/UF. Conclusions Worsening renal failure is associated with a higher CVP at the time of LVAD implantation and increases the risk of 1-year mortality and the odds of requiring HD/UF. Careful evaluation of renal function and comorbid conditions during LVAD implantation is critical to reduce mortality and for risk stratification. |
| Databáze: | OpenAIRE |
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