Hemodynamics and Cardiac Metabolism in Experimental Uremia

Kreußer, W.; Rambausek, M.; Klooker, Pieter; Brückner, U. B.; Ritz, Eberhard

doi:10.1159/000429291

Cited by 2 publications

(1 citation statement)

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“…Studies in uremic rats also show variable decreases in contraction of isolated myocytes along with a decrease in the velocity of shortening and relaxation [21][22][23]. Both energy production and consumption are influenced by uremia [24][25][26]. As a result, increased regional and transmyocardial dispersion of ventricular depolarization in ESRD patients may be a contributory factor in the pathogenesis of increased cardiac arrhythmias and mortality [27].…”

Section: Ckd As the Substrate For Cardiac Arrhythmiasmentioning

confidence: 99%

Chronic Kidney Disease and Sudden Death: Strategies for Prevention

McCullough

Sandberg²

2004

Blood Purif

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The association between chronic kidney disease and cardiovascular death is accounted for, in part, by higher rates of serious arrhythmias. Research shows an independent relationship between worsened renal function and atrial fibrillation, heart block, ventricular tachycardia, ventricular fibrillation, and asystole. These higher rates also associate with underlying structural heart disease including left ventricular hypertrophy, cardiac fibrosis, valvular disease, and left ventricular systolic and diastolic dysfunction. In addition, chronic intermittent ischemia is implicated in the arrhythmias observed during hemodialysis. The superimposed conditions of acidosis and fluxes in both potassium and magnesium also contribute to higher rates of arrhythmias. Baseline estimated glomerular filtration rate is linked to worsened outcomes and increased defibrillation thresholds in patients receiving implantable cardioverter defibrillators. Preventive strategies include meticulous management of electrolytes, baseline treatment for cardiovascular disease, and when indicated, implantable cardioverter defibrillators. Future research into the mechanisms and prevention of sudden cardiac death in patients with chronic kidney disease is warranted.

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