MO358: Analysis of Acute Kidney Injury Incidence in Patients After Left Ventricle Assist Device Implantation

Abstract

BACKGROUND AND AIMS Chronic heart failure (CHF) in the terminal stage is a crucial issue of medicine. Heart transplantation is still the best treatment option. Lack of donors, long waiting time make heart transplantation almost impossible. Implantation of left ventricular assist device—LVAD) in patients with CHF is a bridge to transplantation. Nevertheless, the LVAD implantation procedure is time-consuming, requires significant material costs, and leads to numerous complications in the postoperative period. Acute kidney injury (AKI) is one of the most common and dangerous complications. Issues of AKI in patients with LVAD should be carefully taught. The aim of the study is to examine the incidence of postoperative renal failure after the implantation of LVAD and its relationship to outcomes. In addition, we want to share with our experience of AKI management in patients with LVAD. METHOD A retrospective analysis of 265 medical records of patients after surgical implantation of LVAD who were hospitalized to the National Research Cardiac Surgery Center, Nur-Sultan city, Kazakhstan. Period of hospitalization from 01.2015 to 10.2021 year. The Kidney Disease Improving Global Outcome (KDIGO) criteria were used to define AKI. RESULTS Total number of patients 265 after LVAD implantation. Male—85.66% and female—14.34%. Mean ICU stay of patient without severe AKI—7.17±5.47 days. Mean ICU stay of patient with severe AKI—11.82±7.47 days. Patients with severe AKI and blood purification—59 patients (24.9%), male—61–92.4%, femal—-5–7.6%. Total number of LVAD patients—265. ICU Mortality rate of patients after LVAD implantation—11 patients (4.15%). Severe AKI—59 patients (22.3%). Recovery of AKI—47 patients (79.66%). Transformation to terminal stage of chronic renal disease (CRD) with chronic dialysis—1 patient (1.69%). ICU Mortality rate of patients with severe AKI—11 (18.64%). CONCLUSION AKI is a common complication in the immediate postoperative period after LVAD implantation. AKI negatively affects the outcome of the disease. The mortality rate of LVAD patients with renal insufficiency exceeds by 14% the mortality of patients with renal insufficiency. Blood purification is the effective method of severe AKI therapy.