1. Outcomes in Patients With Chronic Kidney Disease and End-stage Renal Disease and Durable Left Ventricular Assist Device: Insights From the United States Renal Data System Database
- Author
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TARUN Dalia, WAN-CHI CHAN, ANDREW J. SAUER, SAGAR RANKA, AMANDEEP GOYAL, IOANNIS MASTORIS, SUVEENKRISHNA POTHURU, TRAVIS ABICHT, MATTHEW DANTER, ANDRIJA VIDIC, KAMAL GUPTA, RYAN J. TEDFORD, JENNIFER COWGER, JAMES C. FANG, and ZUBAIR SHAH
- Subjects
Heart Failure ,Treatment Outcome ,Humans ,Kidney Failure, Chronic ,Heart-Assist Devices ,Renal Insufficiency, Chronic ,Cardiology and Cardiovascular Medicine ,Medicare ,United States ,Aged ,Retrospective Studies - Abstract
There is paucity of data regarding durable left ventricular assist device (LVAD) outcomes in patients with chronic kidney disease (CKD) stages 3-5 and CKD stage 5 on dialysis (end-stage renal disease [ESRD]).We conducted a retrospective study of Medicare beneficiaries with ESRD and a 5% sample of patients with CKD with an LVAD (2006-2018) to determine 1-year outcomes using the United States Renal Data System database. The LVAD implantation, comorbidities, and outcomes were identified using appropriate International Classification of Diseases, 9th and 10th edition codes. We identified 496 patients with CKD and 95 patients with ESRD who underwent LVAD implantation. The patients with ESRD were younger (59 years vs 66 years; P.001), had more Blacks (40% vs 24.6%, P = .009), compared with the CKD group. The 1-year mortality (49.5% vs 30.9%, P.001) and index mortality (27.4% vs 16.7%, P = .014) rates were higher for patients with ESRD. A subgroup analysis showed significantly higher mortality in ESRD vs CKD 3 (49.5% vs 30.2%, adjusted P = .009), but no significant difference in mortality between stage 3 vs 4/5 (30.2% vs 30.8%, adjusted P = .941). There was no significant difference in secondary outcomes (bleeding, stroke, and sepsis/infection) during follow-up between the 2 groups.Patients with ESRD undergoing LVAD implantation had significantly higher index and 1-year mortality rates compared with patients with CKD.
- Published
- 2021