Impact of chronic kidney disease upon survival among implantable cardioverter-defibrillator recipients.
BACKGROUND
Chronic kidney disease (CKD) has been linked to serious arrhythmias. We studied the impact of CKD upon implantable cardioverter-defibrillator (ICD) recipients.


RESULTS
Baseline estimated glomerular filtration rate (eGFR) was calculated from variables at the time of ICD implantation in 95 patients. Patients with eGFR below 60 ml/min and those with end-stage renal disease (ESRD) were considered to have significant CKD. Among 95 patients who underwent ICD implantation for VT/VF, the mean age was 66.5+/-12.2 years, 27 (29.0%) were women and 20 (21.5%) were African American. The CKD groups (eGFR < 60 ml/min and ESRD) and control group (eGFR > or = 60 ml/min) were similar with respect to background histories and medications. A significant difference in all-cause mortality in those with eGFR >or = 60 ml/min, 3 patients (8.6%), compared to either those with eGFR < 60 ml/min, 28 (60.9%), or ESRD 7 patients (58.3%), p < 0.0001, was noted. Proportionately more patients died from arrhythmic deaths in those with eGFR < 60 ml/min, 8 patients (17.39%) and ESRD 3 patients (25%), than those with eGFR > or = 60 ml/min, no patient. P < or = 0.0001. There was progressive increase in DFT's with worsening renal failure. The Cox proportional hazards model for time until death, found independent predictors to be: age, OR = 1.04 (per year), 95% CI 1.00-1.08, p = 0.04; CKD group, OR 2.59, 95% CI 1.27-5.30, p = 0.009; and use of beta-blockers, OR 0.25, 95% CI 0.10-0.61, p = 0.002.


CONCLUSIONS
Significant CKD was related to overall poor survival, arrhythmic death and high DFTs.
Wase
Abdul
A
Good Samaritan Hospital, Section of Cardiology, Wright State University School of Medicine Dayton, OH 45406, USA. abdul.wase@wright.edu
Basit
Abdul
A
Nazir
Raja
R
Jamal
Ayman
A
Shah
Shalin
S
Khan
Tauseef
T
Mohiuddin
Ishtiaque
I
White
Cynthia
C
Saklayen
Mohammad
M
McCullough
Peter A
PA
D000368:Aged; D016009:Chi-Square Distribution; D017147:Defibrillators, Implantable; D004554:Electric Countershock; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D016019:Survival Analysis; D017180:Tachycardia, Ventricular / Q000150:complications* / Q000401:mortality / Q000628:therapy*