BACKGROUND AND OBJECTIVES: @entity299 ( @entity299 ) is a well established @entity712 treatment that has shown to improve renal function. However, landmark @entity299 trials excluded @entity1 with severe @entity8 . Therefore, this study evaluated the effect of @entity299 on renal function and long-term prognosis in @entity1 with stage 4 CKD. DESIGN, SETTING, @entity1 , _ MEASUREMENTS: This study evaluated 73 consecutive @entity299 @entity1 (71  10 years) with stage 4 CKD who underwent echocardiographic and renal function evaluation at baseline and 6-month follow-up between 2000 and 2012. As a control group, 18 @entity1 with stage 4 CKD who received an @entity737 ( @entity737 ) were selected. @entity299 recipients with >= 15% reduction in left ventricular end-systolic volume at 6-month follow-up were classified as @entity299 responders. During long-term follow-up (median, 33 months), appropriate defibrillator therapy, @entity712 hospitalizations, and all-cause mortality (combined end point) were recorded. RESULTS: At 6-month follow-up, a significant reduction in left ventricular end-systolic volume was observed in @entity299 @entity1 compared with @entity1 with @entity737 (from 159  78 to 145  78 ml in @entity299 @entity1 and from 126  54 to 119  49 ml in @entity737 @entity1 ; P=0.05), and @entity299 response was observed in 22 @entity1 (30%). Compared with @entity737 @entity1 , @entity470 improved among @entity299 @entity1 (from 25  4 to 30  9 ml/min per 1.73 m(2); interaction time and group, P=0.04) and was more pronounced among @entity299 responders (25  3 to 34  9 ml/min per 1.73 m(2); P<0.001). The combined end point was observed in 17 @entity737 and 62 @entity299 @entity1 . @entity299 @entity1 showed superior survival compared with @entity737 @entity1 (log-rank P=0.03). More importantly, @entity299 response was independently associated with improved survival free from the combined end point (hazard ratio, 0.51; 95% confidence interval, 0.27 to 0.98; P=0.04) after adjustment for clinical and echocardiographic parameters. CONCLUSIONS: Response to @entity299 occurs in approximately 30% of @entity1 with stage 4 CKD, which is less than in the average @entity299 population. @entity299 was associated with better clinical outcome, and particularly, @entity299 response was associated with improvement in @entity470 and better long-term prognosis.

Cardiac Resynchronization Therapy in CKD Stage 4 XXXX .

@entity1 :: ('9606', 'Species') :: ['patients', 'PARTICIPANTS'] @entity8 :: ('MESH:D007674', 'Disease') :: ['renal dysfunction'] @entity712 :: ('MESH:D006333', 'Disease') :: ['heart failure'] @entity470 :: ('1956', 'Gene') :: ['eGFR'] @entity737 :: ('MESH:D057873', 'Disease') :: ['implantable cardioverter defibrillator', 'ICD'] @entity299 :: ('MESH:D006331', 'Disease') :: ['CRT', 'Cardiac resynchronization therapy']
@entity1 :: (9606,Species) :: ['Patients']
