{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T19:16:07Z","timestamp":1790363767997,"version":"4.1.0"},"reference-count":23,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Heart Failure"],"published-print":{"date-parts":[[2014,1]]},"abstract":"<jats:sec>\n            <jats:title>Background\u2014<\/jats:title>\n            <jats:p>The long-term durability and prognostic significance of improvement in renal function after mechanical circulatory support (MCS) has yet to be characterized in a large multicenter population. The primary goals of this analysis were to describe serial post-MCS changes in estimated glomerular filtration rate (eGFR) and determine their association with all-cause mortality.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods and Results\u2014<\/jats:title>\n            <jats:p>\n              Adult patients enrolled in the Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) with serial creatinine levels available (n=3363) were studied. Early post-MCS, eGFR improved substantially (median improvement, 48.9%;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001) with 22.3% of the population improving their eGFR by \u2265100% within the first few weeks. However, in the majority of patients, this improvement was transient, and by 1 year, eGFR was only 6.7% above the pre-MCS value (\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001). This pattern of early improvement followed by deterioration in eGFR was observed with both pulsatile and continuous-flow devices. Interestingly, poor survival was associated with both marked improvement (adjusted hazard ratio [HR], 1.64; 95% confidence interval [CI], 1.19\u20132.26;\n              <jats:italic>P<\/jats:italic>\n              =0.002) and worsening in eGFR (adjusted HR, 1.63; 95% CI, 1.15\u20132.13;\n              <jats:italic>P<\/jats:italic>\n              =0.004).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions\u2014<\/jats:title>\n            <jats:p>Post-MCS, early improvement in renal function is common but seems to be largely transient and not necessarily indicative of an improved prognosis. This pattern was observed with both pulsatile and continuous-flow devices. Additional research is necessary to better understand the mechanistic basis for these complex post-MCS changes in renal function and their associated survival disadvantage.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Clinical Trial Registration\u2014<\/jats:title>\n            <jats:p>\n              URL:\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/www.clinicaltrials.gov\">http:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n              . Unique identifier: NCT00119834.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circheartfailure.113.000507","type":"journal-article","created":{"date-parts":[[2013,11,9]],"date-time":"2013-11-09T07:11:28Z","timestamp":1383981088000},"page":"68-75","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":146,"title":["Prevalence and Prognostic Importance of Changes in Renal Function After Mechanical Circulatory Support"],"prefix":"10.1161","volume":"7","author":[{"given":"Meredith A.","family":"Brisco","sequence":"first","affiliation":[{"name":"From the Department of Medicine, Cardiology Division, Medical University of South Carolina, Charleston (M.A.B.); Department of Medicine, Cardiovascular Division (S.E.K., M.J.), and Department of Biostatistics and Epidemiology (S.E.K., M.E.P.), Perelman School of Medicine at the University of Pennsylvania, Philadelphia; Department of Internal Medicine, and the Program of Applied Translational Research, Yale University School of Medicine, New Haven, CT (S.G.C., C.R.P., J.M.T.); and Department of..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen E.","family":"Kimmel","sequence":"additional","affiliation":[{"name":"From the Department of Medicine, Cardiology Division, Medical University of South Carolina, Charleston (M.A.B.); Department of Medicine, Cardiovascular Division (S.E.K., M.J.), and Department of Biostatistics and Epidemiology (S.E.K., M.E.P.), Perelman School of Medicine at the University of Pennsylvania, Philadelphia; Department of Internal Medicine, and the Program of Applied Translational Research, Yale University School of Medicine, New Haven, CT (S.G.C., C.R.P., J.M.T.); and Department of..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven G.","family":"Coca","sequence":"additional","affiliation":[{"name":"From the Department of Medicine, Cardiology Division, Medical University of South Carolina, Charleston (M.A.B.); Department of Medicine, Cardiovascular Division (S.E.K., M.J.), and Department of Biostatistics and Epidemiology (S.E.K., M.E.P.), Perelman School of Medicine at the University of Pennsylvania, Philadelphia; Department of Internal Medicine, and the Program of Applied Translational Research, Yale University School of Medicine, New Haven, CT (S.G.C., C.R.P., J.M.T.); and Department of..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary E.","family":"Putt","sequence":"additional","affiliation":[{"name":"From the Department of Medicine, Cardiology Division, Medical University of South Carolina, Charleston (M.A.B.); Department of Medicine, Cardiovascular Division (S.E.K., M.J.), and Department of Biostatistics and Epidemiology (S.E.K., M.E.P.), Perelman School of Medicine at the University of Pennsylvania, Philadelphia; Department of Internal Medicine, and the Program of Applied Translational Research, Yale University School of Medicine, New Haven, CT (S.G.C., C.R.P., J.M.T.); and Department of..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariell","family":"Jessup","sequence":"additional","affiliation":[{"name":"From the Department of Medicine, Cardiology Division, Medical University of South Carolina, Charleston (M.A.B.); Department of Medicine, Cardiovascular Division (S.E.K., M.J.), and Department of Biostatistics and Epidemiology (S.E.K., M.E.P.), Perelman School of Medicine at the University of Pennsylvania, Philadelphia; Department of Internal Medicine, and the Program of Applied Translational Research, Yale University School of Medicine, New Haven, CT (S.G.C., C.R.P., J.M.T.); and Department of..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wilson W.H.","family":"Tang","sequence":"additional","affiliation":[{"name":"From the Department of Medicine, Cardiology Division, Medical University of South Carolina, Charleston (M.A.B.); Department of Medicine, Cardiovascular Division (S.E.K., M.J.), and Department of Biostatistics and Epidemiology (S.E.K., M.E.P.), Perelman School of Medicine at the University of Pennsylvania, Philadelphia; Department of Internal Medicine, and the Program of Applied Translational Research, Yale University School of Medicine, New Haven, CT (S.G.C., C.R.P., J.M.T.); and Department of..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chirag R.","family":"Parikh","sequence":"additional","affiliation":[{"name":"From the Department of Medicine, Cardiology Division, Medical University of South Carolina, Charleston (M.A.B.); Department of Medicine, Cardiovascular Division (S.E.K., M.J.), and Department of Biostatistics and Epidemiology (S.E.K., M.E.P.), Perelman School of Medicine at the University of Pennsylvania, Philadelphia; Department of Internal Medicine, and the Program of Applied Translational Research, Yale University School of Medicine, New Haven, CT (S.G.C., C.R.P., J.M.T.); and Department of..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey M.","family":"Testani","sequence":"additional","affiliation":[{"name":"From the Department of Medicine, Cardiology Division, Medical University of South Carolina, Charleston (M.A.B.); Department of Medicine, Cardiovascular Division (S.E.K., M.J.), and Department of Biostatistics and Epidemiology (S.E.K., M.E.P.), Perelman School of Medicine at the University of Pennsylvania, Philadelphia; Department of Internal Medicine, and the Program of Applied Translational Research, Yale University School of Medicine, New Haven, CT (S.G.C., C.R.P., J.M.T.); and Department of..."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/circulationaha.109.886473"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2008.07.051"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(02)02823-1"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2007.12.012"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurjhf\/hfq006"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2009.01.022"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2009.01.005"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2005.11.061"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2010.08.019"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1161\/circulationaha.108.814863"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2011.09.038"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2010.10.036"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0909938"},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2011.12.001"},{"key":"e_1_3_4_16_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-145-4-200608150-00004"},{"key":"e_1_3_4_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cardfail.2009.05.015"},{"key":"e_1_3_4_18_2","doi-asserted-by":"publisher","DOI":"10.1161\/circulationaha.108.800011"},{"key":"e_1_3_4_19_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2008.11.034"},{"key":"e_1_3_4_20_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-0029-1240709"},{"key":"e_1_3_4_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(02)04087-0"},{"key":"e_1_3_4_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2007.12.023"},{"key":"e_1_3_4_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(02)03846-8"},{"key":"e_1_3_4_24_2","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.00240605"}],"container-title":["Circulation: Heart Failure"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/CIRCHEARTFAILURE.113.000507","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T01:30:47Z","timestamp":1715563847000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/CIRCHEARTFAILURE.113.000507"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,1]]},"references-count":23,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2014,1]]}},"alternative-id":["10.1161\/CIRCHEARTFAILURE.113.000507"],"URL":"https:\/\/doi.org\/10.1161\/circheartfailure.113.000507","relation":{},"ISSN":["1941-3289","1941-3297"],"issn-type":[{"value":"1941-3289","type":"print"},{"value":"1941-3297","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,1]]},"assertion":[{"value":"2013-01-11","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2013-11-05","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2013-11-08","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}