Impact of Moderate to Severe Chronic Kidney Disease for Long Term Survival of Implantable Cardioverter Defibrillator Patients in Taiwan

The influence of renal impairment on long-term mortality in Taiwanese patients with an ICD was uncertain. The aim of our study was to examine the impact of moderate to severe CKD on outcome in patients with ICD implantation for secondary prevention in Taiwan. From 2005 to 2013, patients who underwent ICD implantation who were survivors of sudden cardiac arrest or unstable hemodynamics due to ventricular arrhythmia at a single medical center were included in this registry. We divided the patients into two groups, group 1 with estimated glomerular filtration rates (eGFRs) of ≥60 mL/(min⋅1.73 cm2) and group 2 with eGFRs of <60 mL/(min⋅1.73 cm2). The clinical end point was defined as the occurrence of all-cause mortality during the follow-up. 84 consecutive patients were enrolled in this registry. The mean age of the patients was 62.7 ± 13.2 years, and 54.8% were male. The patients of group 2 were older (mean age: 66.4 vs. 56.2 years) and had worse renal function (42 ± 12.3 vs. 89.0 ± 18.5 mL/(min⋅1.73 cm2)). They more often had hypertension (56.5% vs. 31.6%), diabetes mellitus (52.2% vs. 15.8%), and previous hospitalization for congestive heart failure as comorbidity (71.7% vs. 28.9%). During the mean follow-up duration of 952 days, 19 patients (22.6%) died. After adjustment for the parameters, eGFRs <60 mL/(min⋅1.73 cm2) was an independent predictor of all-cause mortality (AHR:6.21, 95%CI:1.28–30.06, P = 0.02). Moderate to severe CKD is independently associated with increased mortality in Taiwanese patients who underwent ICD implantation for secondary prevention.