Impact of renal insufficiency on long-term clinical outcome in patients with heart failure treated by cardiac resynchronization therapy

Hosoda, Junya; Ishikawa, Toshiyuki; Matsushita, Kohei; Matsumoto, Katsumi; Kimura, Yuichiro; Miyamoto, Mihoko; Ogawa, Hayato; Takamura, Takeshi; Sugano, Teruyasu; Ishigami, Tomoaki; Uchino, Kenji; Kimura, Kazuo; Umemura, Satoshi

doi:10.1016/j.jjcc.2012.06.001

Cited by 13 publications

(13 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Similarly, we found that a positive GFR improvement, 6 months after CRT implant, is significantly associated with a lower hazard (for each 10 mL/min/1.73 m 2 of GFR improvement HR 0.86; 95% CI 0.75-0.99; p = 0.038). A similar result is also found by Hosoda et al [20] who demonstrated in 67 consecutive patients who underwent CRT that advanced renal insufficiency was an independent predictor of cardiac mortality combined with HF hospitalization (odds ratio 3.01, p = 0.008). Subgroup analysis in the baseline advanced renal insufficiency group revealed that patients with preserved renal function by CRT (< 10% reduction in estimated GFR) had a higher rate of decrease of LV end-systolic diameter (-14.0% vs. -0.8%, p = 0.023) and lower cardiac mortality combined with HF hospitalization (log-rank: p = 0.029) compared with patients with deterioration of renal function (≥ 10% reduction in estimated GFR).…”

Section: Renal Function Improvement After Crt and Mortalitysupporting

confidence: 87%

See 1 more Smart Citation

Renal function impairment predicts mortality in patients with chronic heart failure treated with resynchronization therapy

et al. 2015

View full text Add to dashboard Cite

show abstract

Section: Renal Function Improvement After Crt and Mortalitysupporting

confidence: 87%

“…It has been estimated that as many as 25% to 50% of patients with HF have impaired renal function (creatinine clearance < 60-75 mL/ /min/1.73 m 2 ) [20][21][22]. Recently, a systematic review has examined the effects of CRT in CKD patients (eGFR < 60 mL/min/1.73 m 2 ) with HF.…”

Section: Heart Failure Renal Function and Crtmentioning

confidence: 99%

Renal function impairment predicts mortality in patients with chronic heart failure treated with resynchronization therapy

et al. 2015

View full text Add to dashboard Cite

show abstract

“…Although CRT does not have a direct effect on the kidneys, CRT responders demonstrate a subsequent decrease in sympathetic and RAAS activation, thus conferring an improvement in hemodynamics, mean arterial pressure, and renal perfusion. These improvements have also been associated with better outcomes with CRT (27,32,38).…”

Section: Discussionmentioning

confidence: 88%

“…Forty-eight unique studies were selected for full-text review. Eighteen studies met all inclusion criteria and were included in the systematic review: 14 observational studies and 4 RCTs (11,(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39). To evaluate the effect on survival outcomes, studies were classified into the following two groups: (1) comparing outcomes in all CKD patients who had CRT versus those without CRT and (2) comparing post-CRT outcomes in patients with baseline CKD versus those without CKD.…”

Section: Search Resultsmentioning

confidence: 99%

“…They also reported a trend toward lower prescription of b-blockers and ACEIs (80%-85%) in these patients compared with those with normal renal function at baseline. All studies except one reported eGFR using the modified Modified Diet in Renal Disease (MDRD) study equation (38). Only one study included 17 patients on chronic hemodialysis (24).…”

Section: Study Characteristicsmentioning

confidence: 99%

See 1 more Smart Citation

Cardiac Resynchronization Therapy in CKD

Garg

Thomas

Jackson

et al. 2013

Clinical Journal of the American Society of Nephrology

View full text Add to dashboard Cite

SummaryBackground Cardiac resynchronization therapy (CRT) confers morbidity and mortality benefits to selected patients with heart failure. This systematic review examined effects of CRT in CKD patients (estimated GFR [eGFR] ,60 ml/min per 1.73 m 2 ).Design, setting, participants, & measurements MEDLINE and Scopus (from 1990 to December 2012) and conference proceedings abstracts were searched for relevant observational studies and randomized controlled trials (RCTs). Studies comparing the following outcomes were included: (1) CKD patients with and without CRT and (2) CKD patients with CRT to non-CKD patients with CRT. Mortality, eGFR, and left ventricular ejection fraction data were extracted and pooled when appropriate using a random-effects model.Results Eighteen studies (14 observational studies and 4 RCTs) were included. There was a modest improvement in eGFR with CRT among CKD patients (mean difference 2.30 ml/min per 1.73m 2 ; 95% confidence interval, 0.33 to 4.27). Similarly, there was a significant improvement in left ventricular ejection with CRT in CKD patients (mean difference 6.24%; 95% confidence interval, 3.46 to 9.07). Subgroup analysis of three RCTs reported lower rates of death or hospitalization for heart failure with CRT (versus other therapy) in the CKD population. Survival outcomes of CKD patients (compared with the non-CKD population) with CRT differed among observational studies and RCTs.Conclusions CRT improves left ventricular and renal function in the CKD population with heart failure. Given the increasing use of cardiac devices, further studies examining the effects of CRT on mortality in CKD patients, particularly those with advanced kidney disease, are warranted.

show abstract

Contrast-induced acute kidney injury in patients undergoing cardiac resynchronization therapy—incidence and prognostic importance. Sub-analysis of data from randomized TRUST CRT trial

Kowalczyk

Lenarczyk

Kowalski

et al. 2014

J Interv Card Electrophysiol

View full text Add to dashboard Cite

IntroductionBecause data on contrast-induced acute kidney injury (CI-AKI) in patients undergoing cardiac resynchronization therapy (CRT-D) are scarce, we aimed to assess the incidence, natural course and prognostic importance of this syndrome in CRT recipients.MethodsStudy population consisted of 100 consecutive patients enrolled into the Triple Site Versus Standard Cardiac Resynchronization (TRUST CRT) trial, who were treated with CRT-D. Two patients were excluded up to 3 months after randomization and not analysed further. CI-AKI was defined as a rise in serum creatinine of at least 26.5 μmol/L (0.3 mg/dL) within 48 h after contrast exposure, or at least 50 % increase from the baseline value during index hospital stay with CRT-D implantation according to KDIGO Clinical Practice Guideline for Acute Kidney Injury.ResultsAmong 98 subjects of TRUST CRT trial, 10 patients (10.2 %) developed CI-AKI after CRT-D implantation. In patients with glomerular filtration rate (GFR) <60 mL/min/1.73 m2 on admission, the incidence of CI-AKI was almost twofold (15.4 %) higher than in subjects with GFR ≥60 (8.3 %). CRT-D recipients with CI-AKI had significantly higher mortality rate (50.0 %) compared to those without CI-AKI (17.0 %) during 30 months of follow-up (logrank p = 0.012). Multivariate Cox regression analysis showed CI-AKI as significant and independent risk factor for death in CRT-D recipients (hazard ratio 5.71; 95 % CI 5.16–6.26; p = 0.001).ConclusionsContrast-induced acute kidney injury is a serious and frequent procedural complication of CRT-D implantation with a significant negative influence on long-term survival. The results suggest that clinical evaluation regarding renal function should be considered in CRT-D recipients, both before and after device implantation.

show abstract

Impact of renal insufficiency on long-term clinical outcome in patients with heart failure treated by cardiac resynchronization therapy

Cited by 13 publications

References 19 publications

Renal function impairment predicts mortality in patients with chronic heart failure treated with resynchronization therapy

Renal function impairment predicts mortality in patients with chronic heart failure treated with resynchronization therapy

Cardiac Resynchronization Therapy in CKD

Contrast-induced acute kidney injury in patients undergoing cardiac resynchronization therapy—incidence and prognostic importance. Sub-analysis of data from randomized TRUST CRT trial

Contact Info

Product

Resources

About