Implantable Cardioverter Defibrillators and Chronic Kidney Disease

Kiage, James N; Latif, Zara; Craig, M. A.; Mansour, Nawar; Khouzam, Rami N.

doi:10.1016/j.cpcardiol.2020.100639

Cited by 11 publications

(8 citation statements)

References 53 publications

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“…Evidence regarding the benefits of ICD therapy in CKD patients is still controversial. There are studies that suggest better survival rates with ICD therapy, irrespective of the type of indication [28], while others conclude a higher mortality rate and an elevated burden of antitachycardia pacing or shocks [29]. A major limitation comes from the fact that many studies combine patients with ICD in both primary and secondary prevention, with or without HF.…”

Section: Cied For Sudden Cardiac Death (Scd) Prevention In Ckd Patientsmentioning

confidence: 99%

Cardiac Device Therapy in Patients with Chronic Kidney Disease: An Update

Caba,

Vasiliu,

Covic

et al. 2024

JCM

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Cardiovascular diseases (CVDs) and chronic kidney disease (CKD) are frequently interconnected and their association leads to an exponential increase in the risk of both fatal and non-fatal events. In addition, the burden of arrhythmias in CKD patients is increased. On the other hand, the presence of CKD is an important factor that influences the decision to pursue cardiac device therapy. Data on CKD patients with device therapy are scarce and mostly derives from observational studies and case reports. Cardiac resynchronization therapy (CRT) is associated with decreased mortality, reduced heart failure symptoms, and improved renal function in early stages of CKD. Implantable cardioverter defibrillators (ICDs) are associated with a significant reduction in the mortality of CKD patients only for the secondary prevention of sudden cardiac death. Cardiac resynchronization therapy with defibrillator (CRT-D) is preferred in patients who meet the established criteria. The need for cardiac pacing is increased three-fold in dialysis patients. CKD is an independent risk factor for infections associated with cardiac devices.

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Section: Cied For Sudden Cardiac Death (Scd) Prevention In Ckd Patientsmentioning

confidence: 99%

Cardiac Device Therapy in Patients with Chronic Kidney Disease: An Update

Caba,

Vasiliu,

Covic

et al. 2024

JCM

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“…This is mainly due to the lack of evidence from randomized clinical trials. In particular a metanalysis from ICD trials has indicated no clear benefit from device implantation in CHF patients with reduced renal function [ 188 ], taking also into account the non-arrhythmic causes of death in these patients, as well as the high burden of non-cardiovascular comorbidities, including vascular access, bacteremia, bleeding and higher rates of lead related complications, which are factors that may reduce the net benefit of ICD implantation in in CRS patients [ 189 ].…”

Section: Therapeutic Strategies In Crsmentioning

confidence: 99%

New Insight in Cardiorenal Syndrome: From Biomarkers to Therapy

Gallo

Lanza

Savoia

2023

IJMS

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Cardiorenal syndrome consists in the coexistence of acute or chronic dysfunction of heart and kidneys resulting in a cascade of feedback mechanisms and causing damage to both organs associated with high morbidity and mortality. In the last few years, different biomarkers have been investigated with the aim to achieve an early and accurate diagnosis of cardiorenal syndrome, to provide a prognostic role and to guide the development of targeted pharmacological and non-pharmacological therapies. In such a context, sodium-glucose cotransporter 2 (SGLT2) inhibitors, recommended as the first-line choice in the management of heart failure, might represent a promising strategy in the management of cardiorenal syndrome due to their efficacy in reducing both cardiac and renal outcomes. In this review, we will discuss the current knowledge on the pathophysiology of cardiorenal syndrome in adults, as well as the utility of biomarkers in cardiac and kidney dysfunction and potential insights into novel therapeutics.

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“… Removal of the renal replacement therapy Since the goal of using these techniques in palliative care for cardiorenal patients is to improve symptoms and quality of life, they should be suspended when these goals are not met, especially when there are technical or logistical difficulties in performing the technique, situations of cardiogenic shock, deterioration of frailty, cognitive decline, worsening of quality of life, or the patient's desire. Implantable cardioverter defibrillator (ICD) In the patient with ACKD, the indication for an ICD should be carefully evaluated, as study results suggest that chronic kidney disease may negatively affect the efficacy and safety of the ICD, leading to a higher number of unnecessary ICDs shocks ( 98 ) and more electrode complications (fractures, pacing losses, others) ( 99 ). ACKD itself significantly decreased the event-free survival rate in heart failure patients who received an ICD ( 98 ) and lowered the therapeutic efficacy of the ICD compared to patients without ACKD.…”

Section: Advanced Measures In Cardiorenal Patientsmentioning

confidence: 99%

“… Implantable cardioverter defibrillator (ICD) In the patient with ACKD, the indication for an ICD should be carefully evaluated, as study results suggest that chronic kidney disease may negatively affect the efficacy and safety of the ICD, leading to a higher number of unnecessary ICDs shocks ( 98 ) and more electrode complications (fractures, pacing losses, others) ( 99 ). ACKD itself significantly decreased the event-free survival rate in heart failure patients who received an ICD ( 98 ) and lowered the therapeutic efficacy of the ICD compared to patients without ACKD.…”

Section: Advanced Measures In Cardiorenal Patientsmentioning

confidence: 99%

Consensus document on palliative care in cardiorenal patients

Bonanad,

Buades,

Leiva

et al. 2023

Front. Cardiovasc. Med.

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There is an unmet need to create consensus documents on the management of cardiorenal patients since, due to the aging of the population and the rise of both pathologies, these patients are becoming more prevalent in daily clinical practice. Chronic kidney disease coexists in up to 40%–50% of patients with chronic heart failure cases. There have yet to be consensus documents on how to approach palliative care in cardiorenal patients. There are guidelines for patients with heart failure and chronic kidney disease separately, but they do not specifically address patients with concomitant heart failure and kidney disease. For this reason, our document includes experts from different specialties, who will not only address the justification of palliative care in cardiorenal patients but also how to identify this patient profile, the shared planning of their care, as well as knowledge of their trajectory and the palliative patient management both in the drugs that will help us control symptoms and in advanced measures. Dialysis and its different types will also be addressed, as palliative measures and when the decision to continue or not perform them could be considered. Finally, the psychosocial approach and adapted pharmacotherapy will be discussed.

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Implantable Cardioverter Defibrillators and Chronic Kidney Disease

Cited by 11 publications

References 53 publications

Cardiac Device Therapy in Patients with Chronic Kidney Disease: An Update

Cardiac Device Therapy in Patients with Chronic Kidney Disease: An Update

New Insight in Cardiorenal Syndrome: From Biomarkers to Therapy

Consensus document on palliative care in cardiorenal patients

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