Abstract
OBJECTIVE: We aimed to summarize the characteristics and outcomes of patients undergoing left ventricular assist device (LVAD) implantation, and to determine the incidence, clinical implications, and in-hospital risk factors of acute kidney injury (AKI) requiring continuous renal replacement therapy (CRRT). METHODS: Patients who underwent LVAD implantation from October 2022 to July 2025 were included in this retrospective analysis. Data collection included preoperative and intraoperative baseline characteristics, in-hospital complications, and coronary intensive care unit and total hospital stays. AKI was defined according to the KDIGO criteria. Univariate and multivariate logistic regression were used to identify independent risk factors for CRRT. Receiver operating characteristic curve analysis was used to assess the impact and predictive efficacy of significant variables. RESULTS: Of the 27 patients (median age: 61 years; male: 88.9%), 24 (88.9%) developed AKI and 5 required CRRT postoperatively. Based on CRRT requirement, patients were stratified into two groups: CRRT (n=5) and non-CRRT (n=22). Univariate analysis associated CRRT occurrence to cystatin C levels, duration of vasoactive drug use, ventricular arrhythmias, and fluid balance on the second postoperative day; the duration of vasoactive drug use was revealed as an independent risk factor. The vasoactive-inotropic score (VIS) strongly predicted CRRT occurrence when VIS exceeded 54.5. CONCLUSION: This study found a high incidence of AKI requiring CRRT in patients receiving LVAD implantation. VIS and duration of vasoactive drug use were significant factors linked to CRRT, suggesting the potential of vasoactive drug usage as a predictive indicator for CRRT and further validation through larger-scale studies is still required.