Kidney Week

Abstract: SA-PO338

eGFR Variability in Heart Failure Patients with CardioMEMS Monitoring

Session Information

• Hypertension, CVD, and the Kidneys: Clinical Research
  October 26, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Hypertension and CVD

• 1602 Hypertension and CVD: Clinical

Authors

• Ullman, Lawrence S., Yale University School of Medicine, New Haven, Connecticut, United States

Lawrence S. Ullman

• Beaudry, Paige Nicole, Yale University School of Medicine, New Haven, Connecticut, United States

Paige Nicole Beaudry

• Caldato Barsotti, Gabriel, Yale University School of Medicine, New Haven, Connecticut, United States

Gabriel Caldato Barsotti

• Turner, Jeffrey M., Yale University School of Medicine, New Haven, Connecticut, United States

Jeffrey M. Turner, MD

Group or Team Name

• Yale Nephrology Clinical Research.

Background

Chronic variations in estimated glomerular filtration rate (eGFR) have been associated with an increased risk of stroke, myocardial infarction, and all-cause mortality. Patients with heart failure (HF) are a subpopulation that is commonly associated with variable eGFR. One approach to HF management is the implantation of the CardioMEMS device which allows patients’ providers to remotely monitor their pulmonary artery pressure (PAP) to guide care in real-time. We hypothesized that HF patients who received a CardioMEMS implant may exhibit reduced eGFR variability due to the accessibility of acute PAP data to aid in treatment adjustments for volume regulation.

Methods

This retrospective observational study included HF patients identified from the Yale Heart Failure and Transplant CardioMEMS registry. Creatinine measurements were collected from the 12 months prior to the implantation and the 12 months following implantation. The 2021 CKD-EPI equation was used to calculate eGFR, and eGFR variability was quantified by the coefficient of variation (CV). The CV is defined as the standard deviation of the eGFR measurements divided by the mean eGFR. The primary outcome of interest was the difference in the CV in the pre-and post-CardioMEMS implantation periods.

Results

429 patients received a CardioMEMS implant at Yale between 2017-2023. Of the 429 patients, 424 patients had available creatinine data and were included in the analysis. The mean eGFR of the patient cohort before CardioMEMS implantation was 49.4 mL/min/1.73m² and the mean eGFR post-CardioMEMS implantation was 43.6 mL/min/1.73m² (p < 0.0001). The CV of eGFR demonstrated a nonsignificant decrease of 0.0085 (p=0.2509) when comparing before and after CardioMEMS deployment.

Conclusion

In this cohort of heart failure patients who received a CardioMEMS implant, we did not observe an impact of the CardioMEMS intervention on eGFR variability. However, future research utilizing multivariate modeling to account for potentially confounding variables, such as comorbidities and outpatient medications, is warranted to better understand the impact of CardioMEMS-guided care on renal function.