Background: Although cardiac resynchronisation therapy (CRT) is an important player in the treatment of heart
failure (HF) patients, the proportion of CRT patients with no improvement in either echocardiographic or
clinical parameters remains consistently high and accounts for about 30% despite meeting CRT implantation
criteria. Furthermore, in patients suffering from HF, renal dysfunction accounts for as many as 30-60%.
Accordingly, CRT may improve renal function inducing a systemic haemodynamic benefit leading to increased
renal blood flow.
Objectives: The aim of the present study was to evaluate the importance of renal function in response to
resynchronisation therapy during a 12-month follow-up period.
Materials and methods: The study consisted of 46 HF patients qualified for implantation of cardiac
resynchronisation therapy defibrillator (CRT-D). A CRT responder is defined as a person without chronic HF
exacerbations during observation whose physical efficiency has improved owing to New York Heart
Association (NYHA) class improvement ≥1.
Results: A statistically significant difference was noted between responders and non-responders regarding
creatinine level at the 3rd month (p=0.04) and, particularly, at the 12th month (p=0.02) of follow-up (100±23 vs
139±78 μmol/l). Moreover, there was a remarkable difference between both study groups with regard to GFR
CKD-EPI (glomerular filtration rate (GFR) assessed using the Chronic Kidney Disease Epidemiology
Collaboration (CKD-EPI) formula) at the 6th (p=0.03) and 12th month (p=0.01) of follow-up. The reference
values for initial creatinine concentrations (101 μmol/l) as well as GFR CKD-EPI (63 ml/min/1.73m2
empirically evaluated to predict favourable therapeutic CRT response.
Conclusions: Predictive value of GFR CKD-EPI and creatinine concentration for a positive response to CRT
were found relevant.