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Impact of Chronic Kidney Disease Upon Survival Among Implantable Cardioverter-Defibrillator Recipients

  • Abdul Wase
  • Abdul Basit
  • Raja Nazir
  • Ayman Jamal
  • Shalin Shah
  • Tauseef Khan
  • Ishtiaque Mohiuddin
  • Cynthia White
  • Mohammad Saklayen
  • Peter A. McCullough
Article

Abstract

Background: Chronic kidney disease (CKD) has been linked to serious arrhythmias. We studied the impact of CKD upon implantable cardioverter-defibrillator (ICD) recipients.

Methods and 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≥60 ml/min) were similar with respect to background histories and medications. A significant difference in all-cause mortality in those with eGFR≥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 ≥60 ml/min, no patient. P ≤ 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.

chronic kidney disease ventricular arrhythmias implantable cardioverter-defibrillator mortality 

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Copyright information

© Kluwer Academic Publishers 2004

Authors and Affiliations

  • Abdul Wase
    • 1
  • Abdul Basit
    • 1
  • Raja Nazir
    • 1
  • Ayman Jamal
    • 1
  • Shalin Shah
    • 1
  • Tauseef Khan
    • 1
  • Ishtiaque Mohiuddin
    • 1
  • Cynthia White
    • 1
  • Mohammad Saklayen
    • 2
  • Peter A. McCullough
    • 3
  1. 1.Good Samaritan Hospital, Dayton, Ohio, Section of CardiologyWright State University School of Medicine DaytonOhio
  2. 2.VA Medical Center, Dayton, Ohio, Section of CardiologyWright State University School of Medicine DaytonOhio
  3. 3.Divisions of Cardiology, Nutrition, and Preventive MedicineWilliam Beaumont HospitalRoyal Oak

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