Sudden cardiac death in haemodialysis patients: Preventative options

Chiu, Diana; Sinha, Smeeta; Kalra, Philip A.; Green, Darren

doi:10.1111/nep.12337

Cited by 30 publications

(20 citation statements)

References 66 publications

(121 reference statements)

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“…Nevertheless, the rate of these tragic sudden cardiac death events is more than 25-to 49-fold higher in dialysis patients compared to the general population (1-2 sudden cardiac deaths/1,000 person-years). 3 Sudden death is defined as an unexpected nontraumatic death that occurs within 1 hour of the onset of symptoms. Sudden cardiac death usually occurs due to an acute stressor (trigger), generally in the context of a damaged myocardium.…”

Section: Introductionmentioning

confidence: 99%

Dialysate and Serum Potassium in Hemodialysis

Hung

Hakim

2015

American Journal of Kidney Diseases

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Section: Introductionmentioning

confidence: 99%

Dialysate and Serum Potassium in Hemodialysis

Hung

Hakim

2015

American Journal of Kidney Diseases

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“…Post-dialysis hypokalemia has been associated with life-threatening cardiac arrhythmias and sudden cardiac deaths. The latter is the leading cause of death in the dialysis population, accounting for 25% of the all-cause mortality and 67% of all cardiac deaths [28,29]. The susceptibility to hypokalemia-triggered cardiovascular events could be related to the underlying cardiovascular diseases, occurring in a majority of ESRD patients [28,30].…”

Section: Potassium Derangementsmentioning

confidence: 99%

Electrolyte and Acid-Base Disorders in Chronic Kidney Disease and End-Stage Kidney Failure

Dhondup

Qian²

2017

Blood Purif

157

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The kidneys play a pivotal role in the regulation of electrolyte and acid-base balance. With progressive loss of kidney function, derangements in electrolytes and acid-base inevitably occur and contribute to poor patient outcomes. As chronic kidney disease (CKD) has become a worldwide epidemic, medical providers are increasingly confronted with such problems. Adequate diagnosis and treatment will minimize complications and can potentially be lifesaving. In this review, we discuss the current understanding of the disease process, clinical presentation, diagnosis and treatment strategies, integrating up-to-date knowledge in the field. Although electrolyte and acid-base derangements are significant causes of morbidity and mortality in CKD and end-stage renal disease patients, they can be effectively managed through a timely institution of combined preventive measures and pharmacological therapy. Exciting advances and several upcoming outcome trials will provide further information to guide treatment and improve patient outcomes.

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“…Clinically, however, it is often difficult to distinguish these two pathological conditions unambiguously from each other. Sudden cardiac death is common in both peritoneal dialysis and HD patients and accounts for about one-quarter of mortality in this patient group [13,14]. Given this high occurrence rate, identification of risk factors for sudden death and, thus possibly, opportunities for preventive interventions seem highly required.…”

Section: Introductionmentioning

confidence: 99%

Eccentric Left Ventricular Hypertrophy and Sudden Death in Patients with End-Stage Kidney Disease

Zuijdewijn¹,

Hansildaar²,

Bots

et al. 2015

Am J Nephrol

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Background/Aims: Both all-cause and cardiovascular mortality risks are extremely high in patients with end-stage kidney disease (ESKD). Sudden death accounts for approximately one-quarter of all fatal events. Left ventricular hypertrophy (LVH) is a known risk factor for mortality and can be divided in 2 types: concentric and eccentric. This study evaluated possible differences in all-cause mortality, cardiovascular mortality and sudden death between prevalent ESKD patients with concentric and eccentric LVH. Methods: Participants of the CONvective TRAnsport STudy (CONTRAST) who underwent transthoracic echocardiography (TTE) at baseline were analyzed. In patients with LVH, a relative wall thickness of ≤0.42 was considered eccentric and >0.42 was considered concentric hypertrophy. Cox proportional hazards models, adjusted for potential confounders, were used to calculate hazard ratios (HRs) of patients with eccentric LVH versus patients with concentric LVH for all-cause mortality, cardiovascular mortality and sudden death. Results: TTE was performed in 328 CONTRAST participants. LVH was present in 233 participants (71%), of which 87 (37%) had concentric LVH and 146 (63%) eccentric LVH. The HR for all-cause mortality of eccentric versus concentric LVH was 1.14 (p = 0.52), 1.79 (p = 0.12) for cardiovascular mortality and 4.23 (p = 0.02) for sudden death in crude analyses. Propensity score-corrected HR for sudden death in patients with eccentric LVH versus those with concentric LVH was 5.22 (p = 0.03). Conclusions: (1) The hazard for all-cause mortality, cardiovascular mortality and sudden death is markedly increased in patients with LVH. (2) The sudden death risk is significantly higher in ESKD patients with eccentric LVH compared to subjects with concentric LVH.

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Sudden cardiac death in haemodialysis patients: Preventative options

Cited by 30 publications

References 66 publications

Dialysate and Serum Potassium in Hemodialysis

Dialysate and Serum Potassium in Hemodialysis

Electrolyte and Acid-Base Disorders in Chronic Kidney Disease and End-Stage Kidney Failure

Eccentric Left Ventricular Hypertrophy and Sudden Death in Patients with End-Stage Kidney Disease

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