title: A meta-analysis of mortality in end-stage renal disease patients receiving implantable cardioverter defibrillators (ICDs).
abstract: Data on the effectiveness of implantable implantable cardioverter defibrillators (ICDs) with respect to reducing mortality in patients with chronic kidney disease (CKD) and end-stage renal disease (ESRD) are lacking. The purpose of this meta-analysis was to compare the mortality of patients with ESRD who have received and not received an ICD. A search was conducted on January 31, 2013 of Medline, Cochrane, EMBASE, and Google Scholar. Studies were selected for inclusion based on the following criteria. 1) Randomized controlled trial. 2) ESRD patients with heart failure. 3) Device therapy (ICD, CRT-defibrillator [CRT-D]) used to treat heart failure. 4) Primary outcome is survival analysis. 5) Retrospective study if survival analysis was performed. The primary outcome was overall survival (OS), and the secondary outcome was 2-year survival. Odds ratios (ORs) with 95% confidence intervals (CI) were calculated, and a χ2-based test of homogeneity was performed. Three studies were included in the analysis. The combined OR for OS was 2.245 (95% CI 1.871 to 2.685, P<0.001), indicating that patients with an ICD had a significantly higher OS than those without an ICD. The combined OR for 2-year survival was 2.312 (95% CI 1.921 to 2.784, P<0.001), indicating that patients with an ICD had a significantly higher 2-year survival rate than those without an ICD. The use of ICD in patients with ESRD is associated with an increase in the OS and the 2-year survival rate.
authors.affiliation: Department of Cardiology, Chang-Gung Memorial Hospital, Linko, Taiwan; Department of Cardiology, Chang-Gung Memorial Hospital, Xiamen, China, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
authors.forename: Tien-Hsing
authors.initials: TH
authors.lastname: Chen
authors.affiliation: Department of Cardiology, Chang-Gung Memorial Hospital, Linko, Taiwan.
authors.forename: Hung-Ta
authors.initials: HT
authors.lastname: Wo
authors.affiliation: Department of Cardiology, Chang-Gung Memorial Hospital, Linko, Taiwan.
authors.forename: Po-Cheng
authors.initials: PC
authors.lastname: Chang
authors.affiliation: Department of Cardiology, Chang-Gung Memorial Hospital, Linko, Taiwan.
authors.forename: Chun-Chieh
authors.initials: CC
authors.lastname: Wang
authors.affiliation: Department of Cardiology, Chang-Gung Memorial Hospital, Linko, Taiwan.
authors.forename: Ming-Shien
authors.initials: MS
authors.lastname: Wen
authors.affiliation: Department of Cardiology, Chang-Gung Memorial Hospital, Linko, Taiwan.
authors.forename: Chung-Chuan
authors.initials: CC
authors.lastname: Chou
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017147:Defibrillators, Implantable; D005260:Female; D006333:Heart Failure / Q000150:complications / Q000628:therapy*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications*; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D016032:Randomized Controlled Trials as Topic / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis; D016896:Treatment Outcome