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. 2008 Jun 9;31(6):265–269. doi: 10.1002/clc.20209

The Relationship Between Glomerular Filtration Rate and Survival in Patients Treated with an Implantable Cardioverter Defibrillator

Ronni Levy 1, Andrea DellaValle 2, A Serdar Atav 3, Afazal ur Rehman 4,5, Allan H Sklar 6, Nicolas J Stamato 4,5,✉
PMCID: PMC6653141  PMID: 18543307

Abstract

Objectives

We explored the association between renal insufficiency (RI) and mortality among patients treated with an implantable cardioverter defibrillator (ICD).

Background

Randomized trials have shown improvements in survival among select patients treated with an ICD. Renal insufficiency patients have a high risk of cardiac death; however, it is not clear whether the ICD has a positive effect on survival in this group of patients.

Methods

This was a retrospective review of a single‐center experience of 346 patients treated with an ICD. Patients were stratified into 4 groups according to their glomerular filtration rate (eGFR; expressed as mL/min/ ‐1.73 m2) at implantation: group I, > 75.0; group II, − 60.0 to 74.9; group III, − 45.0 to 59.9; and group IV, − ≤ 45.0. All‐cause mortality was the primary end point, with differences in survival times among the 4 groups of patients expressed in Kaplan‐Meier curves.

Results

Mean follow‐up was 3.5 y (range 0.1 to 12.9 y), during which 67 patients died (19%). Mortality in each eGFR group was: I − 6.8%, II − 13.8%, III − 11.5%, IV − 45.8% (p < 0.001). Survival times (mean, y) were I, 3.74; II, 3.66; III, 3.38, and IV, 2.82. The presence of diabetes was not a factor in the outcomes.

Conclusions

Patients treated with an ICD with an eGFR of ≤ 45.0 mL/min/1.73 m2 have a significantly shorter survival time than those patients with an eGFR > 45.0 mL/min/1.73 m2. Patients with an eGFR > 45.0mL/min/1.73m 2 appear to have equally good outcomes when treated with an ICD. This may have implications for patient selection for ICD therapy. Copyright © 2008 Wiley Periodicals, Inc.

Keywords: implantable cardioverter defibrillator, defibrillator, renal function, renal failure, sudden death

Full Text

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