Vztah a klinický význam chronického onemocnění ledvin u pacientů s poruchami srdečního rytmu a/ nebo s implantabilními elektrickými přístroji
Zkrácená komentovaná verze oficiálního stanoviska Evropské společnosti pro srdeční rytmus

Česká verzia

Authors: P. Heinc; L. Gajdošová; M. Kamasová; J. Látal; J. Přeček; A. Smékal; L. Rec
Authors place of work: I. interní klinika – kardiologická LF UP a FN Olomouc
Published in the journal: Kardiol Rev Int Med 2015, 17(4): 331-338
Category: Cardiology Review

Summary

Chronic kidney disease increases the risk of cardiovascular morbidity and overall mortality, therefore, if heart disease is present, kidney function must be regularly monitored. The pharmacokinetics of drugs is altered in these patients and in dialysed patients the drug may be entirely eliminated from the circulation system, therefore it is necessary to individualise the dose of antiarrhythmic drugs according to the glomerular filtration rate. Catheter ablation for rhythm control is the preferable method in patients with atrial fibrillation. Patients with severe renal insufficiency should not be administered any new anticoagulants; warfarin continues to be indicated instead, with a stricter control of the effective therapeutic range. Patients with implantable electronic devices have a higher risk of complications, especially infectious, and higher total and cardiac mortality. To minimise infectious complications, it is necessary to establish the access route for electrode system implantation on an individual basis, avoid the introduction of dialysis catheter in persons with implants, and where arteriovenous clutches are required, they should be installed on the contralateral side to the implanted device.

Keywords:
kidney disease – heart disease – pharmacokinetics – arrhythmias – thromboembolism – infective complication – implantable electrical devices

Zdroje

1. Eckardt KU, Coresh J, Devuyst O et al. Evolving importance of kidney disease: from subspecialty to global health burden. Lancet 2013; 382: 158– 169. doi: 10.1016/ S0140-6736(13)60439-0.

2. Mafham M, Emberson J, Landray MJ et al. Estimated glomerular filtration rate and the risk of major vascular events and all-cause mortality: a meta-analysis. PLoS One 2011; 6: e25920. doi: 10.1371/ journal.pone.0025920.

3. Tumlin JA, Costanzo MR, Chawla LS et al. Cardiorenal syndrome type 4: insights on clinical presentation and pathophysiology from the eleventh consensus conference of the Acute Dialysis Quality Initiative (ADQI). Contrib Nephrol 2013; 182: 158– 173. doi: 10.1159/ 000349972.

4. Watanabe H, Watanabe T, Sasaki S et al. Close bidirectional relationship between chronic kidney disease and atrial fibrillation: the Niigata preventive medicine study. Am Heart J 2009; 158: 629– 636. doi: 10.1016/ j.ahj.2009.06.031.

5. Goldstein BA, Arce CM, Hlatky MA et al. Trends in the incidence of atrial fibrillation in older patients initiating dialysis in the United States. Circulation 2012; 126: 2293– 2301.

6. Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group. KDIGO 2012 clinical practice guideline for the evaluation and management of chronic kidney disease. Kidney Int Supplements 2013; 3: 1– 150.

7. Roberts PR, Green D. Arrhythmias in chronic kidney disease. Heart 2011; 97: 766– 773. doi: 10.1136/ hrt.2010.208587.

8. Matzke GR, Aronoff GR, Atkinson AJ et al. Drug dosing consideration in patients with acute and chronic kidney disease – a clinical update from Kidney Disease: Improving Global Outcomes (KDIGO). Kidney Int 2011; 80: 1122– 1137. doi: 10.1038/ ki.2011.322.

9. Kaski JC, Baker S, Hayward C et al. Drugs in Cardiology: a Comprehensive Guide to Cardiovascular Pharmacotherapy. London, UK: Oxford University Press 2010.

10. Olesen JB, Lip GY, Kamper AL et al. Stroke and bleeding in atrial fibrillation with chronic kidney disease. N Engl J Med 2012; 367: 625– 635. doi: 10.1056/ NEJMoa1105594.

11. Camm AJ, Lip GY, De Caterina R et al. 2012 focused update of the ESC Guidelines for the management of atrial fibrillation: an update of the 2010 ESC Guidelines for the management of atrial fibrillation – developed with the special contribution of the European Heart Rhythm Association. Europace 2012; 14: 1385– 1413.

12. U.S. Renal Data System, USRDS 2006 Annual Data Report: Atlas of End-Stage Renal Disease in the United States, National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, 2006.

13. Wang AY, LamCW, Chan IH et al. Sudden cardiac death in end-stage renal disease patients: a 5-year prospective analysis. Hypertension 2010; 56: 210– 216. doi: 10.1161/ HYPERTENSIONAHA.110.151167.

14. Goldenberg I, Moss AJ, McNitt S et al. Relations among renal function, risk of sudden cardiac death, and benefit of the implanted cardiac defibrillator in patients with ischemic left ventricular dysfunction. Am J Cardiol 2006; 98: 485– 490.

15. Henderson LW. Symptomatic intradialytic hypotension and mortality: an opinionated review. Semin Dial 2012; 25: 320– 325. doi: 10.1111/ j.1525-139X.2012.01068.x.

16. Navaravong L, Barakat M, Burgon N et al. Improvement in estimated glomerular filtration rate in patients with chronic kidney disease undergoing catheter ablation for atrial fibrillation. J Cardiovasc Electrophysiol 2015; 26: 21– 27. doi: 10.1111/ jce.12530.

17. Haegeli LM, Calkins H. Catheter ablation of atrial fibrillation: an update. Eur Heart J 2014; 35: 2454– 2459. doi: 10.1093/ eurheartj/ ehu291.

18. Garg N, Thomas G, Jackson G et al. Cardiac resynchronization therapy in CKD: a systematic review. Clin J Am Soc Nephrol 2013; 8: 1293– 1303. doi: 10.2215/ CJN.00750113.

19. Cannizzaro LA, Piccini JP, Patel UD et al. Device therapy in heart failure patients with chronic kidney disease. J Am Coll Cardiol 2011; 58: 889– 896. doi: 10.1016/ j.jacc.2011.05.024.

20. Eisen A, Suleiman M, Strasberg B et al. Renal dysfunction and clinical outcomes of patients undergoing ICD and CRTD implantation: data from the Israeli ICD registry. J Cardiovasc Electrophysiol 2014; 25: 990– 997. doi: 10.1111/ jce.12442.

21. Polyzos KA, Konstantelias AA, Falagas ME. Risk factors for cardiac implantable electronic device infection: a systematic review and meta-analysis. Europace 2015; 17: 767– 777. doi: 10.1093/ europace/ euv053.

22. Mittal S, Shaw RE, Michel K et al. Cardiac implantable electronic device infections: incidence, risk factors, and the effect of the AigisRx antibacterial envelope. Heart Rhythm 2014; 11: 595– 601. doi: 10.1016/ j.hrthm.2013.12.013.

23. Diemberger I, Mazzotti A, Giulia MB et al. From lead management to implanted patient management: systematic review and meta-analysis of the last 15 years of experience in lead extraction. Expert Rev Med Devices 2013; 10: 551– 573. doi: 10.1586/ 17434440.2013.811837.