Key result
Renal insufficiency is linked to a ~150% greater risk of CIED infection.
Why the study?
Renal insufficiency is a known risk factor for cardiac implantable electronic device (CIED) infection.
Does renal insufficiency (CKD or ESRD) increase the risk of CIED infection and mortality in patients with cardiac implantable electronic devices?
Meta-Analysis (n=359,784)
Does renal insufficiency (CKD or ESRD) increase the risk of CIED infection and mortality in patients with cardiac implantable electronic devices?
Effect estimate: OR 2.5 (95% CI 1.9-3.3)
p-value: p=<0.001
Renal insufficiency, including both CKD and ESRD, significantly increases the risk of CIED infections, with ESRD additionally increasing the risk of mortality.
Renal insufficiency warrants intensified CIED infection surveillance and prevention; confirms ~2.5-fold risk elevation in large pooled cohorts.
(1) Background: Renal insufficiency is a risk factor for cardiac implantable electronic device (CIED) infection. (2) Methods: A comprehensive search was conducted from multiple electronic databases to identify studies. Using the random effects model, we calculated the pooled rates of CIED infection and their 95% confidence intervals. We also calculated the pooled odds ratios to determine the risk of CIED infections due to chronic kidney disease (CKD) and end-stage renal disease (ESRD). We utilized the Cochran Q and I2 statistics to detect and quantify heterogeneity. (3) Results: A total of 17 studies comprising 359,784 patients with renal insufficiency were added to the meta-analysis. Out of these, 263,819 were CKD patients and 89,617 were ESRD patients. The pooled rate of CIED infection in patients with CKD was 4.3% (95% CI: 2–8.8; I2: 95.7), and in patients with ESRD, it was 4.8% (95% CI: 2.6–8.7; I2: 99.4). The pooled risk of CIED infection in the CKD population was OR 2.5 (95% CI: 1.9–3.3; p < 0.001; I2: 21.1), and in the ESRD population, it was OR 2.4 (95% CI: 1.01–5.7; p = 0.046; I2: 88.8). ESRD was associated with higher mortality, OR 2.5 (95% CI: 1.4–4.4.8; p = 0.001; I2: 95). (4) Conclusions: The presence of renal insufficiency increases the number of CIED infections. In particular, patients with ESRD have an increased risk of mortality.
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Chandramohan et al. (2024) conducted a meta-analysis in Renal insufficiency and cardiac implantable electronic device (CIED) infection (n=359,784). Renal insufficiency (CKD and ESRD) vs. No renal insufficiency was evaluated on CIED infection in the CKD population (OR 2.5, 95% CI 1.9-3.3, p=<0.001). Renal insufficiency significantly increased the risk of CIED infection, with an OR of 2.5 (95% CI 1.9-3.3) for chronic kidney disease and OR 2.4 (95% CI 1.01-5.7) for end-stage renal disease.
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