{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T12:25:23Z","timestamp":1778243123658,"version":"3.51.4"},"reference-count":45,"publisher":"Public Library of Science (PLoS)","issue":"11","license":[{"start":{"date-parts":[[2020,11,30]],"date-time":"2020-11-30T00:00:00Z","timestamp":1606694400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\"><jats:title>Background<\/jats:title><jats:p>Chronic subclinical hemolysis is frequent in patients implanted with Left Ventricular Assist Device (LVAD) and is associated with adverse outcomes. Consequences of LVADs-induced subclinical hemolysis on kidney structure and function is currently unknown.<\/jats:p><\/jats:sec><jats:sec id=\"sec002\"><jats:title>Methods<\/jats:title><jats:p>Thirty-three patients implanted with a<jats:italic>Heartmate II<\/jats:italic>LVAD (Abbott, Inc, Chicago IL) were retrospectively studied. Hemolysis, Acute Kidney Injury (AKI) and the evolution of estimated Glomerular Filtration Rate were analyzed. Proximal Tubulopathy (PT) groups were defined according to proteinuria, normoglycemic glycosuria, and electrolytic disorders. The Receiver Operating Characteristic (ROC) curve was used to analyze threshold of LDH values associated with PT.<\/jats:p><\/jats:sec><jats:sec id=\"sec003\"><jats:title>Results<\/jats:title><jats:p>Median LDH between PT groups were statistically different, 688 IU\/L [642\u2013703] and 356 IU\/L [320\u2013494] in the \u201cPT\u201d and \u201cno PT\u201d groups, respectively p = 0.006. To determine PT group, LDH threshold &gt; 600 IU\/L was associated with a sensitivity of 85.7% (95% CI, 42.1\u201399.6) and a specificity of 84.6% (95% CI, 65.1\u201395.6). The ROC's Area Under Curve was 0.83 (95% CI, 0.68\u20130.98). In the \u201cPT\u201d group, patients had 4.2 [2.5\u20135.0] AKI episodes per year of exposure, versus 1.6 [0.4\u20133.7] in the \u201cno PT\u201d group, p = 0.03. A higher occurrence of AKI was associated with subsequent development of Chronic Kidney Disease (CKD) (p = 0.02) and death (p = 0.05).<\/jats:p><\/jats:sec><jats:sec id=\"sec004\"><jats:title>Conclusions<\/jats:title><jats:p>LVADs-induced subclinical hemolysis is associated with proximal tubular functional alterations, which in turn contribute to the occurrence of AKI and subsequent CKD. Owing to renal toxicity of hemolysis, measures to reduce subclinical hemolysis intensity as canula position or pump parameters should be systematically considered, as well as specific nephroprotective therapies.<\/jats:p><\/jats:sec>","DOI":"10.1371\/journal.pone.0242931","type":"journal-article","created":{"date-parts":[[2020,11,30]],"date-time":"2020-11-30T18:50:28Z","timestamp":1606762228000},"page":"e0242931","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":12,"title":["Hemolysis induced by Left Ventricular Assist Device is associated with proximal tubulopathy"],"prefix":"10.1371","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3714-8768","authenticated-orcid":true,"given":"Tristan","family":"de 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