Publication Date
9-1-2023
Journal
Current Opinion in Nephrology and Hypertension
DOI
10.1097/MNH.0000000000000896
PMID
37195244
PMCID
PMC10524584
PubMedCentral® Posted Date
9-1-2024
PubMedCentral® Full Text Version
Author MSS
Published Open-Access
yes
Keywords
Humans, Heart-Assist Devices, Heart Failure, Kidney, Treatment Outcome, kidney disease, cardiovascular disease, cardiac devices, mechanical circulatory support, left ventricular assist device
Abstract
PURPOSE OF REVIEW: Mechanical circulatory support (MCS) is a group of evolving therapies used for indications ranging from temporary support during a cardiac procedure to permanent treatment of advanced heart failure. MCS is primarily used to support left ventricle function, in which case the devices are termed left ventricular assist devices (LVADs). Kidney dysfunction is common in patients requiring these devices, yet the impact of MCS itself on kidney health in many settings remains uncertain.
RECENT FINDINGS: Kidney dysfunction can manifest in many different forms in patients requiring MCS. It can be because of preexisting systemic disorders, acute illness, procedural complications, device complications, and long-term LVAD support. After durable LVAD implantation, most persons have improvement in kidney function; however, individuals can have markedly different kidney outcomes, and novel phenotypes of kidney outcomes have been identified.
SUMMARY: MCS is a rapidly evolving field. Kidney health and function before, during, and after MCS is relevant to outcomes from an epidemiologic perspective, yet the pathophysiology underlying this is uncertain. Improved understanding of the relationship between MCS use and kidney health is important to improving patient outcomes.
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