The beneficial role of implantable cardioverter defibrillators (ICDs) in patients
with chronic kidney disease (CKD) is controversial. This meta-analysis aimed to evaluate
the effect of ICD on mortality in patients with CKD. A literature search was conducted
for studies reporting the effect of ICD on all-cause mortality in patients with CKD
(estimated glomerular filtration rate <60 ml/min/1.73 m2). The search was not restricted to time or publication status. The search included
the following databases: Ovid MEDLINE, EMBASE, Scopus, Web of Science, Google Scholar,
and EBSCO CINAHL. The primary end point was all-cause mortality. The minimum duration
of follow-up required for inclusion was 1 year. The literature search identified 834
studies, of which 14 studies with 70,661 patients were included. Mean follow-up was
39 months (12 to 81 months). For all patients with CKD, ICD was associated with lower
all-cause mortality (log hazard ratio [HR] −0.247, standard error [SE] 0.101, p = 0.015).
Heterogeneity: degree of freedom = 13 (p <0.01), I2 = 97.057; test for overall effect: Z = −2.431 (p = 0.015). When further stratified based on dialysis, patients with CKD
without the need for dialysis had significantly lower mortality (log HR −0.211, SE
0.095, p = 0.026), with a similar trend in patients who underwent dialysis (log HR
−0.262, SE 0.134, p = 0.051). ICD implantation is associated with a significant mortality
benefit in patients with CKD.
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Article info
Publication history
Published online: December 01, 2022
Received in revised form:
October 6,
2022
Received:
August 7,
2022
Footnotes
Funding: none.
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© 2022 Elsevier Inc. All rights reserved.
