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Abstract

Cardiac arrest represents a significant cause of mortality among patients with End-Stage Renal Disease (ESRD) undergoing renal replacement therapy. This review aimed to synthesize current knowledge on the risk, mechanisms, outcomes and preventative measures for cardiac arrest in this vulnerable population. We conducted a comprehensive literature search in PubMed, identifying both prospective and retrospective studies that reported on cardiac arrest in adult ESRD patients on dialysis. The analysis included variables such as demographics, traditional and non-traditional risk factors and mechanisms of cardiac arrest and prevention strategies. Our review article revealed that cardiovascular disease is a significant burden in ESRD, with cardiac arrest accounting for a significant proportion of mortality. Traditional risk factors included hypertension, diabetes, age, male sex and smoking. Non-traditional risk factors include duration of dialysis treatment, hypotension, inflammation, oxidative stress, mineral bone disorders, electrolyte imbalances, anemia and arrhythmias. Dialysis variables, such as timing, temperature and dialysate composition, were also implicated. We identified several preventative measures, including managing traditional cardiovascular risk factors, modifying dialysis prescriptions, regular cardiac monitoring, consideration of alternative dialysis modalities and medications and optimization of electrolytes and anemia. Our findings underscore the necessity for future research to further understand the intricate relationship between cardiac arrest and hemodialysis, aiming to refine and enhance preventative strategies to improve patient outcomes.