Abstract

Background: This study aimed to investigate the incidence and potentially modifiable risk factors of acute kidney injury (AKI) in patients with cardiac implantable electronic devices (CIED) admitted for removal of infected and non-infected transvenous leads.
Materials and methods: In this observational cohort study, data from 147 consecutive patients with CIED undergoing transvenous lead removal were analyzed. Study endpoint was AKI according to the KDIGO criteria. Multivariable logistic regression analysis was performed to identify independent risk factors for AKI.
Results: Lead removal was performed due to systemic infection (50.3%), isolated pocket infection (34.0%), pocket or lead perforation without infection (13.6%), and endocarditis (2.0%). Out of 147 patients, 34 (23.1%) developed AKI (82.4% stage 1, 8.8% stage 2, and 8.8% stage 3). There was no difference regarding incidence of AKI when separated by infectious vs. non-infectious lead status (25.5 vs. 25.0%) p = 0.605. Defibrillator lead type (HR 24.55, CI 2.41 – 249.97, p = 0.007), necessity to perform laser-assisted lead removal (HR 5.41, CI 1.12 – 26.13, p = 0.035), and time from initial implantation to lead removal (HR 1.01, CI 1.00 – 1.02, p = 0.013) were independent risk factors for AKI. Also, AKI was associated with in-hospital mortality (HR 8.44, CI 2.08 – 34.33, p = 0.003).
Conclusion: Almost a quarter of patients undergoing transvenous lead removal developed AKI. Independent modifiable risk factors for AKI were identified. The role of procedure-related risk factors for AKI, such as lead type and use of laser, needs further evaluation in these patients.

*Equal first authors

Author Details

Authors

• Christoph Edlinger^{1, 2, 3}*
• Marwin Bannehr^{1, 2}*
• Salma Haj-Kheder^{1, 2}
• Viviane Möller^{1, 2}
• Christian Georgi^{1, 2}
• David Reiners^{1, 2}
• Victoria Dworok^{1, 2}
• Anja Haase-Fielitz^{1, 2, 4, 5}
• Christian Butter^{1, 2, 4}

Departments

• ¹ Department of Cardiology, Heart Center Brandenburg, Bernau/Berlin,
• ² Brandenburg Medical School (MHB) “Theodor Fontane”, Neuruppin, Germany,
• ³ Clinic of Internal Medicine II, Department of Cardiology, Paracelsus Medical University of Salzburg, Austria,
• ⁴ Faculty of Health Sciences Brandenburg, Potsdam,
• ⁵ Institute of Social Medicine & Health Care System Research, Otto-von-Guericke University Magdeburg, Magdeburg, Germany

Address

Christoph Edlinger, MD
Department of Cardiology
Heart Center Brandenburg Bernau &
Brandenburg Medical School (MHB) Theodor Fontane
Ladeburger Str. 17
16321 Bernau bei Berlin, Germany
Email: [email protected]

Citation