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首页> 外文期刊>Journal of Clinical Medicine Research >Chronic Kidney Disease in Patients Undergoing Cardiac Device Placement: Results of a Retrospective Study
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Chronic Kidney Disease in Patients Undergoing Cardiac Device Placement: Results of a Retrospective Study

机译：慢性肾病在接受心脏装置的患者中放置：回顾性研究的结果

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Background:Cardiovascular issues (especially arrhythmia and sudden cardiac death) are one of the most common causes of mortality in patients with chronic kidney disease (CKD). To minimize cardiac mortality, these patients frequently require various cardiac devices, such as pacemakers, loop recorders, and defibrillators which can compromise their vascular access. In this study, we aim to determine the prevalence of CKD in patients undergoing cardiac device placement and their progression of CKD.Methods:Institutional review board approval was obtained for this study. A total of 688 patients undergoing cardiac device placement were included in this study over a 3-year period at Jersey Shore University Medical Center. Demographic characteristics, comorbidities, base-line renal functions during the procedure, types of cardiac devices, sites of vascular access and follow-up renal function when available were assessed retrospectively. Patients were categorized into CKD stages 1 - 5 based on the National Kidney Foundation-Kidney Disease Outcomes Quality Initiative (NKF-KDOQI) guidelines. The patients who were already on hemodialysis were excluded in this study.Results:The average age of the patient were 73.9 years with male predominance (60%). A total of 227 patients (33%) had estimated glomerular filtration rate (eGFR) 60 mL/min consistent with the evidence of advanced-stage CKD (stages 3 - 5) at the time of cardiac device placement. The most common types of device placements were new insertion/replacement of atrial and ventricular leads (39.5%), loop recorder implantation (21.1%) and generator changes on an already implanted device (11%). Only 4% (28/688) had a leadless cardiac device placement. The most common access sites were subclavian (47.1%), axillary (32.3%) and femoral (12.2%).Conclusions:The present study demonstrated that nearly one-third of the patient undergoing cardiac device placement had an advanced degree of renal failure. Because CKD is a progressive disease, many of these patients might require renal replacement therapy in the future. Transvenous devices is not a good choice in this group of patients as they will ultimately require an arteriovenous fistula. Subcutaneous leadless cardiac device insertion might be a better option in patients with advanced CKD.Copyright 2020, Hossain et al.
机译：背景：心血管问题（尤其是心律失常和突然的心脏死亡）是慢性肾病（CKD）患者中死亡率最常见的原因之一。为了最大限度地减少心脏死亡率，这些患者经常需要各种心脏装置，例如起搏器，循环记录器和除颤器，可以损害其血管进入。在这项研究中，我们的目的是在进行心脏设备放置患者中确定CKD的患病率及其CKD的进展。方法：为本研究获得了机构审查委员会批准。在泽西岸大学医疗中心的3年期间，共有688名接受心脏设备安置的患者。人口统计学特征，合并症，基线肾功能过程中的过程，追溯评估时，心脏装置的类型，血管通行和随访肾功能的类型。基于国家肾基肾病疾病成果质量倡议（NKF-KDOQI）指南，患者分为CKD阶段1 - 5。在本研究中排除了已经血液透析的患者。结果：患者的平均年龄为73.9岁，男性主要占优势（60％）。总共227名患者（33％）估计肾小球过滤速率（EGFR）<60毫升/分钟，与心脏装置放置时的先进阶段CKD（阶段3-5）的证据一致。最常见的设备放置类型是新插入/更换心房和心室引线（39.5％），环记录器植入（21.1％）和发电机在已经植入的装置上（11％）。只有4％（28/688）有一个无引用的心脏设备放置。最常见的接入站点是亚克拉夫（47.1％），腋生（32.3％）和股骨（12.2％）。结论：本研究表明，接受心脏装置放置的患者的近三分之一具有肾功能衰竭程度。因为CKD是一种渐进性疾病，所以许多患者将来可能需要肾脏替代疗法。乐器设备在这组患者中不是一个不错的选择，因为它们最终需要动脉瘘。皮下无铅心脏装置插入可能是高级CKD.copyright 2020，Hossain等人的患者中更好的选择。

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