Outcomes with LVADs Are Exceedingly Poor in Patients with End-Stage Renal Disease

Mortality after placement of left ventricular assist devices is very high in this patient population.

The use of left ventricular assist devices (LVADs) in patients with refractory advanced heart failure is increasing, both as a “bridge” to cardiac transplantation and as “destination” therapy. Heart failure and kidney dysfunction commonly coexist; the combination of HF and end-stage renal disease (ESRD) is associated with particularly poor prognosis. These researchers used Medicare claims data to assess outcomes in 155 patients with ESRD and 261 patients without ESRD who received a first LVAD between 2003 and 2013.

The patients with ESRD were somewhat younger than those without ESRD (mean age, 58 and 62) but had a higher burden of comorbidity. At a mean follow-up of 2.1 years, 82% of those with ESRD had died, with a median time to death of 1…

Reviewing Author

Frederick A. Masoudi, MD, MSPH, FACC, FAHA

Disclosures

Consultant/Advisory BoardBristol Myers Squibb; CPC Clinical Research

Grant/Research SupportNational Heart, Lung, and Blood Institute

Editorial BoardsUpToDate; American College of Cardiology Self-Assessment Program (SAP)

Leadership Positions in Professional SocietiesAmerican College of Cardiology (Chair, Innovations Committee)