Muslem R, et al. - Researchers here investigated the incidence, predictors and the impact of acute kidney injury (AKI) on mortality and renal function in the first year after left ventricle assist device (LVAD) implantation. Findings revealed highly frequent AKI after LVAD implantation. At one year after LVAD implantation, more severe AKI stages were associated with higher mortality rates and impaired renal function.

Methods

• Researchers conducted a retrospective multi-centre cohort study.
• All patients (age ≥18) undergoing LVAD implantation (91% HeartMate II, 9% HVAD) were included.
• AKI was defined with the definition proposed by the Kidney Disease Improving Global Outcome criteria (KDIGO).

Results

• Overall, researchers included 241 patients (mean age 52.4±12.9 years, 76% male).
• 169 (70%) patients met the AKI criteria.
• Out of these, 109 (45%) had AKI stage I, 22 (9%) stage II and 38 (16%) stage III.
• The need for pre-operative inotropic support and pre-existent chronic kidney disease stage ≤ 2 (eGFR <30 ml/min/1.73 m²) had independent association with the development of AKI and the severity of AKI stages.
• In patients without AKI, AKI stages I, II and III, 1-year mortality rates were 18.7%, 26.4%, 23%, and 51%, respectively (log-rank p=0.001).
• Multivariable analysis suggested that AKI stages ≥ II had independent association with mortality (HR 2.2 (95% CI 1.1-4.5), p=0.027) and worse renal function (β -7.4 (95% CI -12.6 to -2.1), p < 0.01) at 1 year.