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Kidney Injury in Patients with Ventricular Assist Devices

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Abstract

Implantable left ventricular assist devices (LVADs) are an established treatment option for patients with end-stage heart failure (HF) that is refractory to conventional medical therapy. A significant proportion of these patients develop kidney impairment (KI) due to cardiorenal syndrome (CRS), which is often reversible following LVAD implantation, while others develop post-implantation acute kidney injury (AKI) or have chronic kidney disease (CKD) at implantation. The presence of KI has negative impact on clinical outcomes. It is associated with high mortality, lower cardiac transplantation rate, and potential outcome for long-term dialysis. Patients with LVADs who develop AKI necessitating renal replacement therapy (RRT) present unique challenges in their management and require an understanding of the hemodynamic and physiologic consequences of the LVAD during dialysis. This chapter discusses the effects of continuous blood flow on the kidney, various renal outcomes of patients following LVAD implantation, and management of RRT with LVAD.

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Acknowledgements

This material is the result of work supported with resources and the use of facilities at the Baltimore VA Medical Center, MD.

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Authors and Affiliations

  1. Division of Nephrology, Department of Medicine, University of Maryland Medical Center, 22 S. Greene St. N3W143, Baltimore, MD, 21201, USA

    Ami M. Patel

  2. Department of Internal Medicine, University of Maryland Medical Center, 22 South Greene Street, Baltimore, MD, 21201, USA

    Karan Kapoor

  3. Department of Medicine, University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, USA

    Michael R. Rudnick

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  1. Ami M. Patel
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  2. Karan Kapoor
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Correspondence to Ami M. Patel .

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Editors and Affiliations

  1. Department of Internal Medicine, Einstein Medical Center, Sidney Kimmel College of Thomas Jefferson University, Philadelphia, Pennsylvania, USA

    Janani Rangaswami

  2. Department of Medicine, Section of Nephrology, University of Illinois at Chicago, Chicago, Illinois, USA

    Edgar V. Lerma

  3. Department of Nephrology Dialysis and Transplantation, International Renal Research Institute, San Bortolo Hospital, Vicenza, Italy

    Claudio Ronco

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Patel, A.M., Kapoor, K., Rudnick, M.R. (2017). Kidney Injury in Patients with Ventricular Assist Devices. In: Rangaswami, J., Lerma, E., Ronco, C. (eds) Cardio-Nephrology. Springer, Cham. https://doi.org/10.1007/978-3-319-56042-7_18

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  • DOI: https://doi.org/10.1007/978-3-319-56042-7_18

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