J Clin Med Res

Journal of Clinical Medicine Research, ISSN 1918-3003 print, 1918-3011 online, Open Access

Article copyright, the authors; Journal compilation copyright, J Clin Med Res and Elmer Press Inc

Journal website http://www.jocmr.org

Original Article

Volume 9, Number 7, July 2017, pages 596-604

Renal Function and Outcomes With Use of Left Ventricular Assist Device Implantation and Inotropes in End-Stage Heart Failure: A Retrospective Single Center Study

**Table 1.** LVAD Group Versus Inotrope Group
Characteristic	Follow-up time (months)	LVAD group values, mean ± SD or n/N (%)	Inotrope group values, mean ± SD or n/N (%)	P value
Values are mean ± standard deviation or number of patients positive for the characteristic (n) divided by the total number of patients in the group (N). The table depicts baseline characteristic and results for 6 months of follow-up in the LVAD and inotrope groups following LVAD placement or inotrope initiation. CKD: chronic kidney disease; BMI: body mass index; BNP: brain natriuretic peptide.
Age (years)		57.8 ± 14.0	56.9 ± 13.4	0.624
Men		129/169 (76.3%)	14/20 (70%)	0.352
Hypertension		103/169 (60.9%)	15/20 (75%)	0.220
Diabetes mellitus type 2		76/169 (45%)	5/20 (25 %)	0.088
CKD		74/169 (43.8%)	9/20 (45%)	0.918
Tobacco use		81/169 (47.9%)	9/20 (45%)	0.804
BMI (kg/m²)		29.2 ± 6.2	27.5 ± 5.4	0.293
Albumin (mg/dL)	Baseline	3.1 ± 0.6	3.5 ± 0.6	0.013
	3	3.4 ± 0.5	3.6 ± 0.4	0.235
	6	3.6 ± 0.5	3.8 ± 0.5	0.082
BNP (pg/dL)	Baseline	1,206.2 ± 1,214.6	1,199.6 ± 1,005.1	0.674
	3	326.7 ± 302.0	686.6 ± 854.2	0.090
	6	312.1 ± 382.0	583.0 ± 401.1	0.05
Hemoglobin (mg/dL)	Baseline	12.3 ± 1.8	11.3 ± 2.0	0.03
	3	12.1 ± 1.7	11.2 ± 2.1	0.533
	6	11.9 ± 1.7	11.9 ± 1.7	0.621

Table 1. LVAD Group Versus Inotrope Group

Characteristic

Follow-up time (months)

LVAD group values, mean ± SD or n/N (%)

Inotrope group values, mean ± SD or n/N (%)

P value

Values are mean ± standard deviation or number of patients positive for the characteristic (n) divided by the total number of patients in the group (N). The table depicts baseline characteristic and results for 6 months of follow-up in the LVAD and inotrope groups following LVAD placement or inotrope initiation. CKD: chronic kidney disease; BMI: body mass index; BNP: brain natriuretic peptide.

Age (years)

57.8 ± 14.0

56.9 ± 13.4

0.624

Men

129/169 (76.3%)

14/20 (70%)

0.352

Hypertension

103/169 (60.9%)

15/20 (75%)

0.220

Diabetes mellitus type 2

76/169 (45%)

5/20 (25 %)

0.088

CKD

74/169 (43.8%)

9/20 (45%)

0.918

Tobacco use

81/169 (47.9%)

9/20 (45%)

0.804

BMI (kg/m²)

29.2 ± 6.2

27.5 ± 5.4

0.293

Albumin (mg/dL)

Baseline

3.1 ± 0.6

3.5 ± 0.6

0.013

3.4 ± 0.5

3.6 ± 0.4

0.235

3.6 ± 0.5

3.8 ± 0.5

0.082

BNP (pg/dL)

Baseline

1,206.2 ± 1,214.6

1,199.6 ± 1,005.1

0.674

326.7 ± 302.0

686.6 ± 854.2

0.090

312.1 ± 382.0

583.0 ± 401.1

0.05

Hemoglobin (mg/dL)

Baseline

12.3 ± 1.8

11.3 ± 2.0

0.03

12.1 ± 1.7

11.2 ± 2.1

0.533

11.9 ± 1.7

0.621

**Table 2.** LVAD Subgroup Analysis, GFR ≥ 60 mL/min/1.73 m² Versus GFR < 60 mL/min/1.73 m²
Characteristic	Follow-up time, (months)	GFR ≥ 60 mL/min/1.73 m² values, mean ± SD or n/N (%)	GFR < 60 mL/min/1.73 m² values, mean ± SD or n/N (%)	P value
Values are mean ± standard deviation or number of patients positive for the characteristic (n) divided by the total number of patients in the group (N). The table depicts baseline characteristic and results for 24 months of follow up in the group with GFR ≥ 60 mL/min/1.73 m² versus GFR < 60 mL/min/1.73 m². AKI: acute kidney injury; BTT: bridge to transplant; RRT: renal replacement therapy; BMI: body mass index; GFR: glomerular filtration rate; BUN: blood urea nitrogen; BNP: brain natriuretic peptide.
Age (years)		55.4 ± 15.2	59.9 ± 12.2	0.930
Men		60/79 (75.9%)	66/84 (78.6%)	0.690
Hypertension		42/79 (53.1%)	58/84 (69%)	0.037
Diabetes mellitus type 2		33/79 (41.8%)	41/84 (48.8%)	0.367
Tobacco use		39/79 (49.4%)	40/84 (47.6%)	0.823
AKI postoperative		40/79 (50.6%)	39/84 (46.4%)	0.591
BTT rate		22/79 (27.8%)	18/84 (21.4%)	0.341
Need for RRT		2/79 (2.5%)	4/89 (4.8%)	0.450
Mortality over 24 months		26/79 (32.9%)	38/84 (45.2%)	0.107
BMI (kg/m²)		29.5 ± 6.0	29.1 ± 6.5	0.521
GFR (mL/min/1.73 m²)	Baseline	63.6 ± 7.7	39.6 ± 13.9	< 0.001
	3	62.8 ± 16.9	50.8 ± 18.3	< 0.001
	6	62.2 ± 17	50.1 ± 15.8	< 0.001
	9	63.3 ± 18.7	49.1 ± 19.1	< 0.001
	12	59.9 ± 14.1	47.0 ± 15.2	< 0.001
	15	62.3 ± 16.3	48.7 ± 14.9	< 0.001
	18	61.2 ± 17.2	50.9 ± 13.5	< 0.001
	21	60.8 ± 17	48.9 ± 14.6	< 0.001
	24	54.6 ± 16.9	47.6 ± 15.3	< 0.001
BUN (mg/dL)	Baseline	19.2 ± 8.5	32.9 ± 17.6	< 0.001
	3	19.7 ± 13.2	25.1 ± 12.8	0.001
	6	19.6 ± 8.7	24.4 ± 10.6	0.005
	9	20.3 ± 8.2	26.2 ± 12.2	0.004
	12	22.5 ± 10.2	26.5 ± 13.8	0.122
	15	22.9 ± 11.5	24.4 ± 10.7	0.390
	18	21 ± 11.8	23.9 ± 11.0	0.093
	21	22.6 ± 11.8	23.8 ± 13.8	0.827
	24	19.5 ± 8.0	25.3 ± 11.3	0.036
Albumin (mg/dL)	Baseline	3.1 ± 0.6	3.2 ± 0.6	0.498
	3	3.5 ± 0.5	3.4 ± 0.6	0.294
	6	3.6 ± 0.5	3.6 ± 0.5	0.550
	9	3.6 ± 0.5	3.6 ± 0.5	0.520
	12	3.5 ± 0.6	3.5 ± 0.6	0.946
	15	3.5 ± 0.6	3.6 ± 0.5	0.878
	18	3.6 ± 0.6	3.6 ± 0.5	0.896
	21	3.6 ± 0.5	3.5 ± 0.5	0.325
	24	4.0 ± 1.7	3.6 ± 0.5	0.191
BNP (mg/dL)	Baseline	1,035 ± 975.1	1,329.1 ± 1,384.1	0.311
	3	282.3 ± 169.5	372.5 ± 388.4	0.737
	6	305.9 ± 474.1	310.6 ± 284.7	0.619
	9	281.5 ± 301.2	328.8 ± 295.2	0.396
	12	306.7 ± 280.3	363.5 ± 438.3	0.842
	15	395.9 ± 382.6	411.1 ± 603.1	0.807
	18	224.1 ± 173.8	308.9 ± 412.1	0.592
	21	338.5 ± 301.5	329.7 ± 270.2	0.940
	24	269.8 ± 267.7	259.2 ± 181.8	0.670
Hemoglobin (mg/dL)	Baseline	11.4 ± 2	11.2 ± 1.8	0.436
	3	11.5 ± 1.9	11.1 ± 2.0	0.247
	6	11.4 ± 1.8	11.4 ± 1.9	0.889
	9	11.7 ± 2.4	11.5 ± 1.9	0.670
	12	11.7 ± 2.5	11.5 ± 2.2	0.792
	15	11.7 ± 2.3	11.7 ± 1.9	0.930
	18	11.7 ± 2.3	11.5 ± 1.9	0.520
	21	11.9 ± 2.3	11.6 ± 1.6	0.277
	24	11.8 ± 2.1	11.6 ± 2.1	0.683

Table 2. LVAD Subgroup Analysis, GFR ≥ 60 mL/min/1.73 m² Versus GFR < 60 mL/min/1.73 m²

Characteristic

Follow-up time, (months)

GFR ≥ 60 mL/min/1.73 m² values, mean ± SD or n/N (%)

GFR < 60 mL/min/1.73 m² values, mean ± SD or n/N (%)

P value

Values are mean ± standard deviation or number of patients positive for the characteristic (n) divided by the total number of patients in the group (N). The table depicts baseline characteristic and results for 24 months of follow up in the group with GFR ≥ 60 mL/min/1.73 m² versus GFR < 60 mL/min/1.73 m². AKI: acute kidney injury; BTT: bridge to transplant; RRT: renal replacement therapy; BMI: body mass index; GFR: glomerular filtration rate; BUN: blood urea nitrogen; BNP: brain natriuretic peptide.

Age (years)

55.4 ± 15.2

59.9 ± 12.2

0.930

Men

60/79 (75.9%)

66/84 (78.6%)

0.690

Hypertension

42/79 (53.1%)

58/84 (69%)

0.037

Diabetes mellitus type 2

33/79 (41.8%)

41/84 (48.8%)

0.367

Tobacco use

39/79 (49.4%)

40/84 (47.6%)

0.823

AKI postoperative

40/79 (50.6%)

39/84 (46.4%)

0.591

BTT rate

22/79 (27.8%)

18/84 (21.4%)

0.341

Need for RRT

2/79 (2.5%)

4/89 (4.8%)

0.450

Mortality over 24 months

26/79 (32.9%)

38/84 (45.2%)

0.107

BMI (kg/m²)

29.5 ± 6.0

29.1 ± 6.5

0.521

GFR (mL/min/1.73 m²)

Baseline

63.6 ± 7.7

39.6 ± 13.9

< 0.001

62.8 ± 16.9

50.8 ± 18.3

< 0.001

62.2 ± 17

50.1 ± 15.8

< 0.001

63.3 ± 18.7

49.1 ± 19.1

< 0.001

59.9 ± 14.1

47.0 ± 15.2

< 0.001

62.3 ± 16.3

48.7 ± 14.9

< 0.001

61.2 ± 17.2

50.9 ± 13.5

< 0.001

60.8 ± 17

48.9 ± 14.6

< 0.001

54.6 ± 16.9

47.6 ± 15.3

< 0.001

BUN (mg/dL)

Baseline

19.2 ± 8.5

32.9 ± 17.6

< 0.001

19.7 ± 13.2

25.1 ± 12.8

0.001

19.6 ± 8.7

24.4 ± 10.6

0.005

20.3 ± 8.2

26.2 ± 12.2

0.004

22.5 ± 10.2

26.5 ± 13.8

0.122

22.9 ± 11.5

24.4 ± 10.7

0.390

21 ± 11.8

23.9 ± 11.0

0.093

22.6 ± 11.8

23.8 ± 13.8

0.827

19.5 ± 8.0

25.3 ± 11.3

0.036

Albumin (mg/dL)

Baseline

3.1 ± 0.6

3.2 ± 0.6

0.498

3.5 ± 0.5

3.4 ± 0.6

0.294

3.6 ± 0.5

0.550

3.6 ± 0.5

0.520

3.5 ± 0.6

0.946

3.5 ± 0.6

3.6 ± 0.5

0.878

3.6 ± 0.6

3.6 ± 0.5

0.896

3.6 ± 0.5

3.5 ± 0.5

0.325

4.0 ± 1.7

3.6 ± 0.5

0.191

BNP (mg/dL)

Baseline

1,035 ± 975.1

1,329.1 ± 1,384.1

0.311

282.3 ± 169.5

372.5 ± 388.4

0.737

305.9 ± 474.1

310.6 ± 284.7

0.619

281.5 ± 301.2

328.8 ± 295.2

0.396

306.7 ± 280.3

363.5 ± 438.3

0.842

395.9 ± 382.6

411.1 ± 603.1

0.807

224.1 ± 173.8

308.9 ± 412.1

0.592

338.5 ± 301.5

329.7 ± 270.2

0.940

269.8 ± 267.7

259.2 ± 181.8

0.670

Hemoglobin (mg/dL)

Baseline

11.4 ± 2

11.2 ± 1.8

0.436

11.5 ± 1.9

11.1 ± 2.0

0.247

11.4 ± 1.8

11.4 ± 1.9

0.889

11.7 ± 2.4

11.5 ± 1.9

0.670

11.7 ± 2.5

11.5 ± 2.2

0.792

11.7 ± 2.3

11.7 ± 1.9

0.930

11.7 ± 2.3

11.5 ± 1.9

0.520

11.9 ± 2.3

11.6 ± 1.6

0.277

11.8 ± 2.1

11.6 ± 2.1

0.683

**Table 3.** LVAD Group Results
Characteristic	Follow-up time (months)	Baseline values, mean ± SD	Follow-up values, mean ± SD	P value
GFR (mL/min/1.73 m²)	3	53.1 ± 15.4	56.9 ± 18.5	0.013
	6	53.3 ± 15.1	56.3 ± 17.8	0.049
	9	54.2 ± 14.7	56.7 ± 20.1	0.133
	12	53.9 ± 14.5	53.7 ± 15.9	0.860
	15	54.1 ± 14.9	55.6 ± 16.9	0.399
	18	53.9 ± 15.2	55.8 ± 16.1	0.280
	21	53.9 ± 15.0	54.5 ± 16.9	0.758
	24	54.8 ± 13.8	54.6 ± 16.9	0.950
BUN (mg/dL)	3	25.2 ± 13.7	22.3 ± 13.2	0.024
	6	24.9 ± 13.1	21.8 ± 9.8	0.006
	9	24.6 ± 13.2	23.3 ± 10.9	0.255
	12	24.8 ± 13.2	24.5 ± 12.3	0.826
	15	24.4 ± 12.5	23.5 ± 10.9	0.587
	18	24.8 ± 12.9	22.4 ± 11.2	0.119
	21	24.9 ± 13.6	23.9 ± 13.8	0.600
	24	24.1 ± 12.4	23.0 ± 10.9	0.465
Albumin (mg/dL)	3	3.2 ± 0.5	3.4 ± 0.5	0.001
	6	3.2 ± 0.6	3.6 ± 0.5	< 0.001
	9	3.2 ± 0.5	3.6 ± 0.5	< 0.001
	12	3.2 ± 0.5	3.5 ± 0.6	0.001
	15	3.3 ± 0.5	3.6 ± 0.6	0.002
	18	3.3 ± 0.5	3.6 ± 0.6	0.001
	21	3.3 ± 0.5	3.5 ± 0.6	0.011
	24	3.2 ± 0.5	3.7 ± 0.6	< 0.001
BNP (pg/mL)	3	1,010.1 ± 1,112.9	333.8 ± 303.7	< 0.001
	6	1,009.4 ± 1,154.2	303.4 ± 377.2	< 0.001
	9	894.8 ± 995.4	315.0 ± 303.4	< 0.001
	12	917.5 ± 1,105.1	345.6 ± 384.5	< 0.001
	15	830.4 ± 1,199.6	401.5 ± 528.0	0.024
	18	830.4 ± 1,117.4	277 ± 335.0	0.007
	21	738.8 ± 1,162.4	333.4 ± 282.2	0.071
	24	781.9 ± 1,157.5	268.0 ± 223.5	0.015
Hemoglobin (mg/dL)	3	10.9 ± 1.9	11.2 ± 2.1	0.181
	6	10.9 ± 2.0	11.4 ± 2.0	0.067
	9	10.8 ± 2.0	11.5 ± 2.4	0.017
	12	10.8 ± 1.9	11.5 ± 2.5	0.015
	15	10.9 ± 1.8	11.7 ± 2.1	0.020
	18	10.8 ± 1.7	11.6 ± 2.0	0.015
	21	0.9 ± 1.7	11.8 ± 1.9	0.009
	24	11.0 ± 1.9	11.8 ± 1.9	0.044

Table 3. LVAD Group Results

Characteristic

Follow-up time (months)

Baseline values, mean ± SD

Follow-up values, mean ± SD

P value

GFR (mL/min/1.73 m²)

53.1 ± 15.4

56.9 ± 18.5

0.013

53.3 ± 15.1

56.3 ± 17.8

0.049

54.2 ± 14.7

56.7 ± 20.1

0.133

53.9 ± 14.5

53.7 ± 15.9

0.860

54.1 ± 14.9

55.6 ± 16.9

0.399

53.9 ± 15.2

55.8 ± 16.1

0.280

53.9 ± 15.0

54.5 ± 16.9

0.758

54.8 ± 13.8

54.6 ± 16.9

0.950

BUN (mg/dL)

25.2 ± 13.7

22.3 ± 13.2

0.024

24.9 ± 13.1

21.8 ± 9.8

0.006

24.6 ± 13.2

23.3 ± 10.9

0.255

24.8 ± 13.2

24.5 ± 12.3

0.826

24.4 ± 12.5

23.5 ± 10.9

0.587

24.8 ± 12.9

22.4 ± 11.2

0.119

24.9 ± 13.6

23.9 ± 13.8

0.600

24.1 ± 12.4

23.0 ± 10.9

0.465

Albumin (mg/dL)

3.2 ± 0.5

3.4 ± 0.5

0.001

3.2 ± 0.6

3.6 ± 0.5

< 0.001

3.2 ± 0.5

3.6 ± 0.5

< 0.001

3.2 ± 0.5

3.5 ± 0.6

0.001

3.3 ± 0.5

3.6 ± 0.6

0.002

3.3 ± 0.5

3.6 ± 0.6

0.001

3.3 ± 0.5

3.5 ± 0.6

0.011

3.2 ± 0.5

3.7 ± 0.6

< 0.001

BNP (pg/mL)

1,010.1 ± 1,112.9

333.8 ± 303.7

< 0.001

1,009.4 ± 1,154.2

303.4 ± 377.2

< 0.001

894.8 ± 995.4

315.0 ± 303.4

< 0.001

917.5 ± 1,105.1

345.6 ± 384.5

< 0.001

830.4 ± 1,199.6

401.5 ± 528.0

0.024

830.4 ± 1,117.4

277 ± 335.0

0.007

738.8 ± 1,162.4

333.4 ± 282.2

0.071

781.9 ± 1,157.5

268.0 ± 223.5

0.015

Hemoglobin (mg/dL)

10.9 ± 1.9

11.2 ± 2.1

0.181

10.9 ± 2.0

11.4 ± 2.0

0.067

10.8 ± 2.0

11.5 ± 2.4

0.017

10.8 ± 1.9

11.5 ± 2.5

0.015

10.9 ± 1.8

11.7 ± 2.1

0.020

10.8 ± 1.7

11.6 ± 2.0

0.015

0.9 ± 1.7

11.8 ± 1.9

0.009

11.0 ± 1.9

11.8 ± 1.9

0.044