Worsening Renal Function after Ventricular Assist Device Placement Is Associated with Twice the Risk of Death over 3 Years

Abstract

all-cause mortality and secondary outcomes of time to heart transplantation and dialysis. Results: Baseline characteristics were notable for a mean age of 56±13 years, 54% ischemic cardiomyopathy, 45% destination therapy, 53% HMII device, and 445±476 days on device. Of the 160 patients, WRF developed in 38 (24%) at 3 months after implant. In multivariate regression tree analysis, longer LVAD operative duration and lower preimplant total bilirubin were independently associated with a higher risk of WRF. During a median follow-up of 2.2 years, there were 56 heart transplants, 34 cases of dialysis, and 70 deaths from all causes. WRF was associated with a nonsignificant lower rate of heart transplantation (HR 0.4; CI 0.2, 1.2; P= 0.12). WRF was associated with significantly higher rates of dialysis (HR 4.0; CI 1.8, 9.1; P< 0.001) and worse survival (HR 2.7; CI 1.5, 4.9; P= 0.001). Conclusion: WRF occurs in nearly one out of four CF LVAD patients. At any point after implant, LVAD recipients with WRF had 2.7 times the risk of death and 4.0 times the risk of needing dialysis.