Renal resistive index in patients supported with a durable continuous flow left ventricular assist device

Background The impact of continuous flow resulting from contemporary left ventricular assist devices (LVAD) on renal vascular physiology is unknown. Renal resistive index (RRI) reflects arterial compliance, as well as renal vascular resistance, contributed by afferent and efferent arteriolar tone, t...

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Bibliographic Details
Published in:Artificial organs 2024-11, Vol.48 (11), p.1366-1371
Main Authors: Barua, S., Robson, D., Eckford, H., Macdonald, P., Muthiah, K., Hayward, C. S.
Format: Article
Language:English
Subjects:
Adult
Aged
Blood pressure
Capillary flow
Capillary pressure
Congestive heart failure
Continuous flow
Correlation
Female
Heart Failure - physiopathology
Heart Failure - surgery
Heart Failure - therapy
Heart-Assist Devices
Hemodynamics
Humans
Kidney - blood supply
Kidney - diagnostic imaging
Kidney - physiopathology
Kidney diseases
Kidney transplantation
left ventricular assist device
Male
Middle Aged
Prospective Studies
Pulmonary arteries
Pulmonary artery
Renal failure
Renal function
Renal replacement therapy
renal resistive index
Sensory neurons
Transplants & implants
Ultrasonography, Doppler
Vascular Resistance
Ventricle
Ventricular assist devices
Waveforms
worsening renal function
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Summary:Background The impact of continuous flow resulting from contemporary left ventricular assist devices (LVAD) on renal vascular physiology is unknown. Renal resistive index (RRI) reflects arterial compliance, as well as renal vascular resistance, contributed by afferent and efferent arteriolar tone, the renal interstitium as well as renal venous pressures. Methods Prospective, single center study with renal Doppler evaluation at baseline (pre‐implant) and at 3‐months support. Outcomes assessed include need for post‐operative renal replacement therapy (RRT), worsening renal function (WRF) defined as persistent increase from pre‐implant KDIGO chronic kidney disease stage, right ventricular (RV) failure, and survival to transplantation. Results Pre‐implant RRI did not predict cardiorenal outcomes including right heart failure, need for renal replacement therapy or worsening renal function. Post‐implant RRI was significantly lower than pre‐implant RRI, with a distinct Doppler waveform characteristic of continuous flow. Post‐implant renal end‐diastolic velocity, but not RRI, correlated strongly with LVAD flow (Spearman rho −0.99, p 
ISSN:0160-564X
1525-1594
1525-1594
DOI:10.1111/aor.14854