title: Renal function after implantation of continuous versus pulsatile flow left ventricular assist devices.
abstract: BACKGROUND
  This study was designed to determine the effect of continuous vs pulsatile flow devices on renal function after left ventricular assist device (LVAD) implantation.
  
  
  METHODS
  Ninety-two patients undergoing LVAD implantation as bridge-to-transplant therapy were retrospectively analyzed. Patients receiving continuous flow devices (n = 63, 68.5%) were compared with patients receiving pulsatile flow devices (n = 29, 31.5%). Renal function was assessed by 2 calculated glomerular filtration rates (GFR) using the Modification of Diet in Renal Disease (MDRD)-derived GFR (ml/min/1.73 m(2)) and the Cockcroft-Gault-derived creatinine clearance (CrCl, ml/min).
  
  
  RESULTS
  Mean GFR/CrCl was comparable between the groups at LVAD implantation, in the post-implantation period, and at transplantation. Both groups had a significant increase in mean GFR at Week 1 post-implantation (continuous, 59.4 +/- 22.8 to 76.4 +/- 38.6, p = 0.001; pulsatile, 52.5 +/- 21.1 to 69.2 +/- 34.7; p = 0.007), Week 4 (continuous, 59.9 +/- 23.0 to 84.3 +/- 32.9; p < 0.001; pulsatile, 50.3 +/- 21.1 to 79.9 +/- 38.7, p = 0.007), and Week 12 (continuous, 60.3 +/- 23.1 to 75.3 +/- 30.2, p = 0.004; pulsatile, 55.5 +/- 23.1 to 74.2 +/- 27.2, p = 0.037) that was also seen with the Cockcroft-Gault-calculated CrCl. No significant increase occurred in mean GFR/CrCl to transplantation. Incidence of post-implantation renal failure was comparable between the groups (continuous, 38.1%; pulsatile, 31.0%; p = 0.512).
  
  
  CONCLUSIONS
  After LVAD implantation, patients with continuous flow devices and patients with pulsatile flow devices have comparable renal function.
authors.affiliation: Department of Cardiothoracic Surgery, Medical University of Vienna, Vienna, Austria. sigrid.sandner@meduniwien.ac.at
authors.forename: Sigrid E
authors.initials: SE
authors.lastname: Sandner
authors.forename: Daniel
authors.initials: D
authors.lastname: Zimpfer
authors.forename: Philipp
authors.initials: P
authors.lastname: Zrunek
authors.forename: Daniela
authors.initials: D
authors.lastname: Dunkler
authors.forename: Heinrich
authors.initials: H
authors.lastname: Schima
authors.forename: Angela
authors.initials: A
authors.lastname: Rajek
authors.forename: Michael
authors.initials: M
authors.lastname: Grimm
authors.forename: Ernst
authors.initials: E
authors.lastname: Wolner
authors.forename: Georg M
authors.initials: GM
authors.lastname: Wieselthaler
mesh_terms: D003404:Creatinine / Q000097:blood*; D005260:Female; D005919:Glomerular Filtration Rate; D006333:Heart Failure / Q000150:complications / Q000601:surgery*; D006353:Heart-Assist Devices; D006801:Humans; D007668:Kidney / Q000502:physiology*; D007674:Kidney Diseases / Q000209:etiology; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
chemical_list: D003404:Creatinine