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Oct 04, 2013

Dialysis Patients with Heart Failure May Benefit from Pacemakers

Despite initial concerns, pacemakers may be safe and effective for treating heart failure in patients with end-stage kidney disease.

About half of patients with end-stage kidney disease develop heart failure, which can have a drastic impact on both outcomes and quality of life. While pacemakers can alleviate heart failure symptoms like shortness of breath, most doctors shy away from this treatment for fear of complications. They worry that dialysis patients’ health may be too compromised to handle such a therapy and the benefits would be minimal, if at all. But a recent study suggests that pacemakers may not only be safe, they could help improve outcomes and quality of life for certain dialysis patients.

Published in the American Journal of Cardiology, this small study used data from Massachusetts General Hospital to identify patients with end-stage kidney disease and heart failure who received a pacemaker (small device that controls heart rhythm) between 2002 and 2012. After identifying 15 patients that fit these criteria, researchers then compared them with similar patients who had pacemakers and heart failure, but were not on permanent dialysis. Contrary to typical concerns, researchers found that pacemaker implantation was just as safe for dialysis-dependent vs. non-dialysis-dependent patients with heart failure. Not only were no serious complications observed in patients with end-stage kidney disease, certain patients experienced significant health benefits after receiving the device.

While this study was both small and only included patients from a single hospital, findings could spark further, more robust research around this topic. Pacemakers may not be appropriate for all dialysis patients, but it’s possible that this therapy could benefit certain patients depending on their health status and personal preferences. Kidney disease and heart failure are two chronic conditions that require a wealth of resources to treat and most importantly, take a significant toll on patients’ quality of life. The more we understand about weighing the risks and benefits of certain treatments, the more options patients have to manage their conditions and help improve outcomes.

Questions for You to Consider

  • What are common heart failure symptoms?

  • Heart failure symptoms often present themselves slowly but progress and worsen over time. These symptoms include shortness of breath; swelling of feet, ankles or abdomen; fatigue; cough and weight gain.


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