Tolerability of Intermittent Hemodialysis in a Cohort of Patients with Left Ventricular Assist Device

Authors

Christopher Areephanthu, University of Kentucky
Amr Elhusseini, University of KentuckyFollow
Bennet George, University of Kentucky
Jessica McAbee, University of Kentucky
B. Peter Sawaya, University of KentuckyFollow

Peer Reviewed

1

Publication Date

11-5-2016

Document Type

Original Research

Abstract

Background: The use of left ventricular assist device (LVAD) has emerged as a popular treatment for patients with advanced heart failure. It is not uncommon for these patients to suffer from renal failure requiring renal replacement therapy. The purpose of this study is to assess hemodynamic parameters and ability to complete the prescribed hemodialysis session in a series of patients who underwent numerous dialysis treatments.

Methods: Nine patients with Heart Mate II LVAD received 170 intermittent inpatient hemodialysis treatments between January 1, 2010 and December 31, 2012. Assessment included vital signs, ultrafiltrate removed, hemodialysis duration, symptoms, early terminations (ET), and adverse events during each hemodialysis session.

Results: The mean age was 53 ± 18 with a range of 26-83 years, with a male predominance (7/9). Indication for LVAD was as destination therapy (DT) in the majority of patients (6/9). Nine patients who received a total of 170 hemodialysis sessions with a mean prescribed and achieved: ultrafiltration (liters) 1.98 ± 1.5 and 1.90 ± 1.6; hemodialysis duration (hours) 3.12 ± 0.3 and 2.86 ± 0.9, respectively. Early termination was experienced in 11 sessions (6.5%). Causes of ET were hypotension in 72.7%, other causes were equally distributed between clotted extra-corporeal circuits, nausea & vomiting and LVAD alarm (9.1% in each). Serious arrhythmias were not observed in any of the hemodialysis treatments. Six out of nine patients (66.7%) recovered kidney function and became dialysis independent.

Conclusion: In a hospital setting, patients with LVAD can often tolerate and complete the prescribed hemodialysis treatment.

DOI

https://doi.org/10.13023/VAD.2016.25

Creative Commons License

This work is licensed under a Creative Commons Attribution-Noncommercial 4.0 License

Recommended Citation

Areephanthu, Christopher; Elhusseini, Amr; George, Bennet; McAbee, Jessica; and Sawaya, B. Peter (2016) "Tolerability of Intermittent Hemodialysis in a Cohort of Patients with Left Ventricular Assist Device," The VAD Journal: Vol. 2, Article 25.
DOI: https://doi.org/10.13023/VAD.2016.25
Available at: https://uknowledge.uky.edu/vad/vol2/iss1/25