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Cardiac Implantable Electronic Device Infections in Patients with Renal Insufficiency: A Systematic Review and

Deepak Chandramohan1, Prabhat Singh2, Hari Naga Garapati3

  • 1Department of Internal Medicine/Nephrology, University of Alabama at Birmingham, Birmingham, AL 35233, USA.

Diseases (Basel, Switzerland)
|October 25, 2024
PubMed

Insights

Renal insufficiency significantly increases the risk of cardiac implantable electronic device infections. Patients with end-stage renal disease face a higher risk of mortality alongside these infections.

Area of Science:

  • Cardiology
  • Nephrology
  • Infectious Diseases

Background:

  • Renal insufficiency is a known risk factor for cardiac implantable electronic device (CIED) infections.
  • Understanding the specific risks associated with different stages of renal disease is crucial for patient management.

Purpose of the Study:

  • To quantify the pooled rates and risks of CIED infections in patients with renal insufficiency.
  • To assess the association between chronic kidney disease (CKD) and end-stage renal disease (ESRD) and CIED infection risk and mortality.

Main Methods:

  • A systematic literature search was performed across multiple electronic databases.
  • A meta-analysis using random-effects models was conducted to pool infection rates and odds ratios.
  • Cochran Q and I2 statistics were used to assess heterogeneity.

Main Results:

  • The meta-analysis included 17 studies with 359,784 patients; 263,819 with CKD and 89,617 with ESRD.
  • Pooled CIED infection rates were 4.3% for CKD and 4.8% for ESRD.
  • CKD patients had an odds ratio (OR) of 2.5 for CIED infection, while ESRD patients had an OR of 2.4. ESRD was also linked to a 2.5-fold increased mortality risk.

Conclusions:

  • Renal insufficiency is associated with a significantly increased incidence of CIED infections.
  • Patients with end-stage renal disease exhibit a particularly elevated risk of mortality in conjunction with CIED infections.

Keywords:
cardiac implantable electronic devicechronic kidney diseasedevice-related infectionsend-stage renal diseaserenal insufficiency

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