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Acute Kidney Injury in the Era of Ventricular Assist Devices

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Perioperative Kidney Injury

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Abstract

Ventricular assist devices (VADs) are an increasingly used therapy for advanced heart failure in the United States; over 10,000 patients have durable mechanical circulatory support since 2006. Renal dysfunction is common in these patients, particularly those who are not candidates for cardiac transplantation and receive a VAD as a destination therapy. Presence of baseline renal dysfunction translates into a greater risk of acute kidney injury (AKI) following VAD placement, which in turn portends a poor prognosis. However, the majority of patients actually experience a relative improvement in renal function with mechanical support suggesting that a significant burden of reversible heart failure-induced renal dysfunction was present in these patients at baseline. The clinical significance of post-VAD improvements in renal function remains poorly understood. This chapter describes the changes in renal function after VAD implantation, their association with mortality, and the potential influence of continuous-flow technology on these renal outcomes.

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Authors and Affiliations

  1. Division of Cardiology, Section of Advanced Heart Failure and Cardiac Transplantation, Medical University of South Carolina, 25 Courtenay Drive, ART 7061, MSC 592, Charleston, SC, 29425-5920, USA

    Meredith A. Brisco MD, MSCE

  2. Program of Applied Translational Research, Yale University, 60 Temple Street, Suite 6C, New Haven, CT, 06510, USA

    Jeffrey M. Testani MD, MTR

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  1. Meredith A. Brisco MD, MSCE
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Correspondence to Meredith A. Brisco MD, MSCE .

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Editors and Affiliations

  1. Division of Nephrology and Hypertension, University of Cincinnati, Cincinnati, Ohio, USA

    Charuhas V. Thakar

  2. Program of Applied Translational Research, Department of Medicine, Yale University School of Medicine, New Haven, Connecticut, USA

    Chirag R. Parikh

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Brisco, M.A., Testani, J.M. (2015). Acute Kidney Injury in the Era of Ventricular Assist Devices. In: Thakar, C., Parikh, C. (eds) Perioperative Kidney Injury. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-1273-5_9

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