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Cardiac Resynchronization Therapy prevents progression of renal failure in heart failure patients.

Authors :
Jeevanantham V
Turagam M
Shanberg D
Reddy M
Atoui M
Daubert JP
Dawn B
Lakkireddy D
Source :
Indian pacing and electrophysiology journal [Indian Pacing Electrophysiol J] 2016 Jul - Aug; Vol. 16 (4), pp. 115-119. Date of Electronic Publication: 2016 Nov 11.
Publication Year :
2016

Abstract

Background: The goal of this study is to assess the effect of cardiac resynchronization therapy (CRT) over time on renal function and its impact on mortality. The effect of CRT on renal function in patients with heart failure is not well understood.<br />Methods: All patients who underwent CRT implantation at University of Kansas between year 2000 and 2009 were reviewed and patients who had pre and post CRT renal function studied were included in our study. Stages of chronic kidney disease (CKD) were defined based on Kidney Disease Outcome Quality Initiative (KDOQI) guidelines. The effect of CRT on renal and cardiac function were studied at short term (≤6 months post implantation) and long term (>6 months).<br />Results: A total of 588 patients with mean age of 67 ± 12 yrs were included in the study. CRT responders (defined by increase in LVEF ≥ 5%) were 54% during short term follow-up and 65% on long term follow-up. When compared to baseline, there was no significant deterioration in mean Glomerular Filtration Rate (GFR) during follow up. When analyzed based on the stages of CKD, there was significant improvement of renal function in patients with advanced kidney disease. Multivariate logistic regression analysis showed that stable GFR or an improvement in GFR independently predicted mortality after adjusting for co-morbidities.<br />Conclusions: CRT was associated with stabilization of renal function in patients with severe LV dysfunction and improvement in stage 4 and 5 CKD. Improved renal function was associated with a lower mortality.<br /> (Copyright © 2016 Indian Heart Rhythm Society. Production and hosting by Elsevier B.V. All rights reserved.)

Details

Language :
English
ISSN :
0972-6292
Volume :
16
Issue :
4
Database :
MEDLINE
Journal :
Indian pacing and electrophysiology journal
Publication Type :
Academic Journal
Accession number :
27924757
Full Text :
https://doi.org/10.1016/j.ipej.2016.11.006