Gürcü Mustafa Emre, Altaş Yerlikhan Özge, Özer Tanıl, Erkılınç Atakan, Altınay Ece, Erdem Esin, Gücün Murat, Bekiroğlu Nural, Kırali Kaan
Department of Anesthesiology and Reanimation, Kartal Koşuyolu Yüksek İhtisas Training and Research Hospital, İstanbul, Turkey.
Department of Cardiovascular Surgery, Kartal Koşuyolu Yüksek İhtisas Training and Research Hospital, İstanbul, Turkey.
Turk Gogus Kalp Damar Cerrahisi Derg. 2019 Jun 14;27(3):320-328. doi: 10.5606/tgkdc.dergisi.2019.17568. eCollection 2019 Jul.
In this study, we aimed to investigate the mid-term effects of left ventricular assist devices on kidney functions.
Between January 2015 and December 2017, a total of 61 patients (53 males, 8 females; mean age 46.4±11.2 years; range, 20 to 67 years) who underwent left ventricular assist device implantation were retrospectively analyzed. Glomerular filtration rate was evaluated preoperatively and at 24 and 48 h, at one week, and at one, three, and six months postoperatively. According to the preoperative glomerular filtration rates, the patients were divided into three groups: glomerular filtration rates ?60 mL/min/1.73 m2 ( Group 1 ), g lomerular f iltration rates 61-90 mL/min/1.73 m2 (Group 2), and glomerular filtration rates >90 mL/min/1.73 m2 (Group 3).
In all groups, the glomerular filtration rate significantly increased at one week and one month postoperatively, compared to preoperative values (p<0.001 and p<0.01, respectively). However, the glomerular filtration values at six months significantly decreased, compared to the values at one week and one month postoperatively (p<0.001 and p<0.001, respectively). The most significant drop to preoperative values was observed in Group 3 (p=0.02) at three months and it dropped below the preoperative level at six months (p<0.001).
Our study results suggest that left ventricular assist devices can significantly increase the glomerular filtration rate in short-term, irrespective of baseline values. However, this improvement may recede later, particularly in patients with normal renal functions, and it may even disappear following the third postoperative month.
在本研究中，我们旨在调查左心室辅助装置对肾功能的中期影响。
回顾性分析2015年1月至2017年12月期间共61例行左心室辅助装置植入术的患者（53例男性，8例女性；平均年龄46.4±11.2岁；范围20至67岁）。术前、术后24小时和48小时、1周、1个月、3个月和6个月评估肾小球滤过率。根据术前肾小球滤过率，将患者分为三组：肾小球滤过率≤60 mL/min/1.73 m2（第1组）、肾小球滤过率61 - 90 mL/min/1.73 m2（第2组）和肾小球滤过率>90 mL/min/1.73 m2（第3组）。
与术前值相比，所有组术后1周和1个月时肾小球滤过率均显著升高（分别为p<0.001和p<0.01）。然而，与术后1周和1个月时的值相比，6个月时的肾小球滤过值显著降低（分别为p<0.001和p<0.001）。第3组在3个月时降至术前值的降幅最为显著（p = 0.02），6个月时降至术前水平以下（p<0.001）。
我们的研究结果表明，无论基线值如何，左心室辅助装置在短期内均可显著提高肾小球滤过率。然而，这种改善可能在后期消退，尤其是肾功能正常的患者，甚至可能在术后第三个月后消失。
