Vanerio Gabriel, García Cristina, González Carlota, Ferreiro Alejandro
CASMU Arrhythmia Service, 8 de Octubre 3310, 11600 Montevideo, Uruguay ; British Hospital, Avenida Italia 2420, 11600 Montevideo, Uruguay.
CASMU Arrhythmia Service, 8 de Octubre 3310, 11600 Montevideo, Uruguay.
Int J Nephrol. 2014;2014:284172. doi: 10.1155/2014/284172. Epub 2014 May 26.
End stage renal disease is a relatively frequent disease with high mortality due to cardiac causes. Permanent pacemaker (PM) implantation rates are also very common; thus combination of both conditions is not unusual. We hypothesized that patients with chronic kidney disease with a PM would have significantly higher mortality rates compared with end stage renal disease patients without PM. Our objectives were to analyze mortality of patients on renal replacement therapy with PM. 2778 patients were on renal replacement therapy (RRT) and 110 had a PM implanted during the study period. To reduce the confounding effects of covariates, a propensity-matched score was performed. 52 PM patients and 208 non-PM matched patients were compared. 41% of the PM were implanted before entering the RRT program and 59% while on RRT. Mortality was higher in the PM group. Cardiovascular disease and infections were the most frequent causes of death. Propensity analysis showed no differences in long-term mortality between groups. We concluded that in patients on RRT and PM mortality rates are higher. Survival curves did not differ from a RRT propensity-matched group. We concluded that the presence of a PM is not an independent mortality risk factor in RRT patients.
终末期肾病是一种相对常见的疾病,因心脏原因导致的死亡率很高。永久性起搏器(PM)植入率也非常普遍;因此,这两种情况同时出现并不罕见。我们假设,与没有植入PM的终末期肾病患者相比,患有慢性肾病且植入了PM的患者死亡率会显著更高。我们的目标是分析接受肾脏替代治疗且植入了PM的患者的死亡率。在研究期间,2778名患者接受了肾脏替代治疗(RRT),其中110名植入了PM。为了减少协变量的混杂效应,进行了倾向匹配评分。对52名植入PM的患者和208名匹配的未植入PM的患者进行了比较。41%的PM是在进入RRT项目之前植入的,59%是在接受RRT期间植入的。植入PM的患者组死亡率更高。心血管疾病和感染是最常见的死亡原因。倾向分析显示两组之间的长期死亡率没有差异。我们得出结论,接受RRT且植入PM的患者死亡率更高。生存曲线与RRT倾向匹配组没有差异。我们得出结论,PM的存在不是RRT患者独立的死亡风险因素。