Abstract 13561: Hospital Outcomes of Chronic Kidney Disease Patients After Transvenous Lead Removal of Infected Cardiac Implantable Electronic Devices

Abstract

Background: Chronic kidney disease (CKD) is a common comorbidity among patients who require transvenous lead removal (TLR) of infected cardiac implantable electronic devices (CIED). However, its impact on the outcomes of this procedure remains unclear. Objective: This study aimed to investigate the impact of CKD and end-stage renal disease (ESRD) on the outcomes following TLR of infected CIED. Method: Using the Nationwide Readmissions Database, we identified and analyzed the hospital outcomes of patients aged ≥18 years, who underwent TLR of infected CIED from 2017 to 2020. The patient cohort was further stratified by the presence of CKD diagnoses. Survey-based weighted univariable and multivariable analyses were performed to investigate whether CKD of different stages independently predicts worse outcomes among these patients. Results: A total of 10,928 patients who underwent TLR of infected CIED were included in our study. Amongst, 3,794 (34.7%) patients had CKD not requiring dialysis, and 605 (5.5%) patients had ESRD on dialysis. The patients with ESRD on dialysis had the highest rates of early mortality (10.6% vs 7.7% vs 4.1%, p<0.01), non-home discharge (46.1% vs 43.3% vs 30.5%, p<0.01), prolonged hospitals stay (90.6% vs 84.9% vs 72.6%, p<0.01), and 30-day readmission (25.5% vs 24.6% vs 17.1%, p<0.01) compared to CKD not requiring dialysis patients and non-CKD patients. Via multivariable analyses, the risk of poorer in-hospital outcomes increased with the severity of CKD. Apart from cardiac arrest, CKD was not significantly associated with increased procedural complications following the TLR procedure. Conclusion: Chronic kidney disease, particularly ESRD was associated with poorer hospital outcomes following TLR of infected CIED. The procedural complications were not significantly increased in CKD patients, except for cardiac arrest. These highlight the importance of meticulous peri-procedural management in CKD patients.