Plasma and dialysate potassium concentrations and haemodialysis associated mortality

Adam, W. R.

doi:10.1111/nep.12140

Cited by 4 publications

(2 citation statements)

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“…4,5 The etiology of sudden death, in particular, remains incompletely understood. A clear relationship between the timing of dialysis sessions and episodes of sudden death 6,7 as well as studies demonstrating associations with serum or dialysate electrotype concentrations [8][9][10][11] have strongly implicated arrhythmia as the principal cause of sudden deaths on dialysis. However, sudden deaths are frequently unwitnessed, and the only autopsy study to investigate the etiology of sudden death in chronic dialysis patients included only 35 patients and identified dissecting aortic aneurysm rather than primary arrhythmia as the most frequent sudden death trigger.…”

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confidence: 99%

A Systematic Review of the Incidence of Arrhythmias in Hemodialysis Patients Undergoing Long-Term Monitoring With Implantable Loop Recorders

Roberts

Stromberg

Johnson

et al. 2021

Kidney International Reports

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Introduction: Establishing the frequency and nature of arrhythmias in hemodialysis (HD) is an important step in improving outcomes of these patients. We undertook this systematic review and meta-analysis to characterize arrhythmia frequency in maintenance HD patients. Methods:We identified studies on arrhythmias in adult patients on maintenance HD detected via implantable loop recorders (ILRs). Studies included were in English and reported ILR-detected arrhythmia incidence in HD patients. Data were extracted by one author using electronic spreadsheets and verified by a second author. Random effects models were used for pooled inferences. The I 2 statistic was used to quantify heterogeneity.Results: Five studies qualified for inclusion (317 patients). The overall estimates for the annualized rate of death and sudden cardiac death (SCD) was 0.14 (95% confidence interval [CI]: 0.11-0.18) and 0.06 (95% CI: 0.03-0.10), respectively. Across all 5 studies, the combined annualized rate of patients experiencing at least 1 bradycardia/asystole event was 0.19 (95% CI: 0.11-0.33) but heterogeneity was high (I 2 ¼ 79.8%). The average annualized rate of sustained ventricular tachycardia (VT) or ventricular fibrillation (VF) episodes (0.02, 95% CI: 0.01-0.05) was significantly lower (P < 0.001) than the rate of bradycardia/asystole reported in the same patients. Incidence of atrial fibrillation (AF) varied significantly across the studies (from 0.07 to 0.83 patients per year) reflecting variable definitions (new-onset vs. total number of episodes). Conclusion:The incidence of arrhythmias among chronic HD patients is high, with bradycardia/asystole occurring more frequently than ventricular arrhythmias. Additional studies to refine estimates particularly of AF are needed.

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confidence: 99%

A Systematic Review of the Incidence of Arrhythmias in Hemodialysis Patients Undergoing Long-Term Monitoring With Implantable Loop Recorders

Roberts

Stromberg

Johnson

et al. 2021

Kidney International Reports

View full text Add to dashboard Cite

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“…Based on the initial title and abstract screening, 397 studies were excluded. Out of the 308 remaining articles, we excluded 262 other studies also due to different reasons: dietary potassium intake and mortality in long‐term CKD patients (Noori et al., 2010 ), dialysate potassium and risk of death in chronic hemodialysis (HD) patients (Adam, 2013 ; Al‐Ghamdi et al., 2010 ; Huang et al., 2015 ), urinary potassium excretion and mortality (Eisenga et al., 2016 ; He et al., 2016 ; Leonberg‐Yoo et al., 2017 ), potassium gradient categories and mortality (Brunelli et al., 2017 ), effect of different drugs on serum potassium levels (Bragg‐Gresham et al., 2007 ; Chan et al., 2010 ; Heerspink et al., 2014 ). Moreover, 22 studies were also excluded because they were not conducted in CKD patients and one study investigated Paraquat poisoning.…”

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confidence: 99%