Left Ventricular Assist Devices, Kidney Disease, and Dialysis

Publication date: Available online 14 December 2017 Source:American Journal of Kidney Diseases Author(s): Bethany Roehm, Amanda R. Vest, Daniel E. Weiner Left ventricular assist devices (LVADs) improve survival in patients with advanced heart failure. As LVAD use increases, so do the number of patients with LVADs who also have kidney disease. However, there are only sparse data on how best to care for these patients. This review provides an overview of LVAD principles and indications, including blood pressure assessment and criteria for receipt of both destination and bridge to transplantation LVADs. Following LVAD implantation, kidney function may improve in the short term, particularly if cardiorenal physiology was present; in the longer term, data remain limited. Individuals with glomerular filtration rates chronically < 30mL/min/1.73m2, including those treated with maintenance dialysis, are generally ineligible for destination LVADs. However, select patients with advanced chronic kidney disease can be considered for LVADs as a bridge to heart or heart-kidney transplantation. Patients who develop acute kidney injury and require dialysis following LVAD implantation have high mortality rates. Although thrice-weekly hemodialysis is the most common modality for patients with LVADs, peritoneal dialysis and home hemodialysis are additional options. Peritoneal dialysis in particular may be associated with lower risk for bloodstream infection and fewer hemodynamic shifts....
Source: American Journal of Kidney Diseases - Category: Urology & Nephrology Source Type: research

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Authors: Peris A, Girardi E, Bombardi M, Seghieri G PMID: 31820873 [PubMed - as supplied by publisher]
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Source: The Lancet - Category: General Medicine Source Type: research
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Source: Best Practice and Research Clinical Endocrinology and Metabolism - Category: Endocrinology Source Type: research
Fight Aging! provides a weekly digest of news and commentary for thousands of subscribers interested in the latest longevity science: progress towards the medical control of aging in order to prevent age-related frailty, suffering, and disease, as well as improvements in the present understanding of what works and what doesn't work when it comes to extending healthy life. Expect to see summaries of recent advances in medical research, news from the scientific community, advocacy and fundraising initiatives to help speed work on the repair and reversal of aging, links to online resources, and much more. This content is...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
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Source: The Lancet - Category: General Medicine Source Type: research
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Source: Journal of Cardiovascular Medicine - Category: Cardiology Tags: Research articles: Acute heart failure Source Type: research
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Source: American Journal of Kidney Diseases - Category: Urology & Nephrology Source Type: research
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