Author + information
- Rahat Muslema,b,
- Kadir Caliskana,b,
- Sakir Akina,b,
- Dennis A. Hesselinka,b,
- Glenn Whitmana,b,
- Ryan Tedforda,b,
- Ad J.J.C. Bogersa,b,
- Olivier Manintvelda,b and
- Stuart Russella,b
Background: This study evaluated the predictive value of proteinuria before Left Ventricular Assist Device (LVAD) implantation in relation to renal failure and mortality during the first-year.
Methods: A retrospective multicentre cohort study was conducted, evaluating all LVAD patients (n=241) implanted in the two participating centres with age ≥18 years and minimal survival >48 hrs. A urinary dipstick was available in 201 (83%) patients within a 7-day period before LVAD. Proteinuria was defined as ≥trace (≥1+) and renal failure as the need for renal replacement therapy. Exclusion criteria were; positive for microscopic haematuria (>3 RBC/hpf or positive dipstick for haematuria), 28 patients were excluded.
Results: Overall, 173 patients met the inclusion criteria (mean age 52.3±13.3, 78% male, mean eGFR at baseline 60.1±25.9 mL/min per 1.73 m2), of whom 42 (24%) had significant proteinuria (mean age 54, 76% male, mean eGFR 60±32.3 mL/min per 1.73 m2). During the first-year 32% of the patients with proteinuria vs. 16% without proteinuria developed severe renal failure (adjusted HR 2.47, 95% CI 1.18 to 5.15, p=0.016). The 1-year survival was 52% in patients with proteinuria vs. 78% in patients without proteinuria (Log-rank p<0.001, Figure 1). In multivariate analysis proteinuria was identified as an independent predictor of 1-year mortality (HR 2.09, 95% CI 1.14 to 3.84, p=0.017).
Conclusions: Proteinuria in patients undergoing LVAD implantation was highly associated with renal failure and mortality.
Moderated Poster Contributions
Heart Failure and Cardiomyopathies Moderated Poster Theater, Poster Hall, Hall C
Sunday, March 19, 2017, 1:15 p.m.-1:25 p.m.
Session Title: Advanced Therapies = Advanced Trouble: VAD and Transplant Challenges
Abstract Category: 13. Heart Failure and Cardiomyopathies: Clinical
Presentation Number: 1318M-09
- 2017 American College of Cardiology Foundation