Journal article
Outcomes of Device Extraction in Patients with Chronic Kidney Disease on Renal Replacement Therapy and Cardiac Implantable Electronic Device Infections
Heart rhythm, Vol.22(9), pp.e757-e762
09/2025
DOI: 10.1016/j.hrthm.2024.11.052
PMID: 39615815
Abstract
Patients with chronic kidney disease (CKD) on renal replacement therapy (RRT) are at high risk for cardiovascular implantable electronic device (CIED) infections. Although device extraction is standard management, it is often avoided in these patients due to high procedural risks.
Evaluate the outcomes of CIED extraction in CKD on RRT patients with device infection.
This study utilized data from the TriNetX research network. The International Classification of Diseases-10
Revision-Clinical Modification coding system was used to identify patients. Adults with a history of CKD on RRT and CIED infection were included. Patients with renal transplantation and prosthetic heart valves were excluded. Patients were stratified by device extraction. The primary outcome was mortality at one year.
A total of 530 patients were identified, of whom 30% (n=159) underwent device extraction. Following propensity score matching (PSM), 302 patients remained, with 151 in each group. Kaplan-Meier survival analysis demonstrated a significant one-year survival benefit for patients in the device extraction group (59.2%) compared to the no-extraction group (48.8%, p=0.043, HR 0.696, 95% CI 0.489-0.991). Freedom from complications such as pericardial effusion was similar between groups. Sensitivity analysis using Cox proportional hazards, adjusted for baseline confounders, confirmed the survival benefit of extraction, with a reduced mortality risk (HR 0.581, 95% CI 0.382-0.883, p=0.011)."
In CKD on RRT patients with CIED infection, device extraction is associated with a reduction in all-cause mortality at one year. However, the rate of device extraction is low in this group.
Details
- Title: Subtitle
- Outcomes of Device Extraction in Patients with Chronic Kidney Disease on Renal Replacement Therapy and Cardiac Implantable Electronic Device Infections
- Creators
- Ashraf Alzahrani - University of IowaLillie Lamont - University of Iowa Hospitals and ClinicsMohammed Mhanna - University of IowaPeter Farjo - University of IowaE Michael Powers - University of IowaSteven Bailin - University of IowaPaari Dominic - University of Iowa Hospitals and Clinics
- Resource Type
- Journal article
- Publication Details
- Heart rhythm, Vol.22(9), pp.e757-e762
- DOI
- 10.1016/j.hrthm.2024.11.052
- PMID
- 39615815
- NLM abbreviation
- Heart Rhythm
- ISSN
- 1547-5271
- eISSN
- 1556-3871
- Language
- English
- Electronic publication date
- 11/28/2024
- Date published
- 09/2025
- Academic Unit
- Cardiovascular Medicine; Internal Medicine
- Record Identifier
- 9984757064702771
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