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Zeng YQ, Qin ZA, Guo ZW, Li B, Yu HY, Chen RX, Tang YQ, Hu KJ, Guan CJ, Yan R. Non-linear relationship between basal serum albumin concentration and cardiac arrest in critically ill patients with end-stage renal disease: a cross-sectional study. BMJ Open 2022; 12:e051721. [PMID: 35135767 PMCID: PMC8830225 DOI: 10.1136/bmjopen-2021-051721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES The aim of our study was to investigate the association between serum albumin concentration and the risk of cardiac arrest in critically ill patients with end-stage renal disease in the intensive care unit (ICU). DESIGN This was a secondary analysis. SETTING The Phillip electronic-ICU collaborative database from 2014 to 2015. PARTICIPANTS This study included 4990 critically ill patients diagnosed with end-stage renal disease. PRIMARY AND SECONDARY OUTCOME MEASURES The exposure of interest was serum albumin concentration. The outcome variable was cardiac arrest. RESULTS A non-linear relationship was observed between serum albumin concentration and risk of cardiac arrest, with an inflection point of 3.26 g/dL after adjusting for potential confounders. The effect sizes and the CIs on the left and right sides of the inflection point were 0.88 (0.65 to 1.19) and 0.32 (0.16 to 0.64), respectively. CONCLUSIONS Within an albumin range of 3.26-5.6 g/dL, each 1 g/dL increase in serum levels is associated with a 68% decrease of the risk of cardiac arrest in critically ill patients with end-stage renal disease.
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Affiliation(s)
- Yong-Qin Zeng
- Department of Nephrology, The Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, China
| | - Zuo-An Qin
- Department of Cardiology, The First People' s Hospital of Changde City, Changde, China
| | - Zi-Wei Guo
- Department of Nephrology, The Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, China
| | - Bo Li
- Department of Nephrology, The Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, China
| | - Hai-Yan Yu
- Department of Nephrology, The Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, China
| | - Rui-Xue Chen
- Department of Nephrology, The Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, China
| | - Ying-Qian Tang
- Department of Nephrology, The Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, China
| | - Ke-Jin Hu
- Department of Nephrology, The Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, China
| | - Cheng-Jing Guan
- Department of Nephrology, The Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, China
| | - Rui Yan
- Department of Nephrology, The Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, China
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Schwantes-An TH, Vatta M, Abreu M, Wetherill L, Edenberg HJ, Foroud TM, Chertow GM, Moe SM. The Contribution of Known Familial Cardiovascular Disease Genes to Sudden Cardiac Death in Patients Undergoing Hemodialysis. Cardiorenal Med 2021; 11:174-183. [PMID: 34433165 PMCID: PMC8393692 DOI: 10.1159/000517123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 05/03/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Patients with chronic kidney disease experience high rates of cardiovascular mortality and morbidity. When kidney disease progresses to the need for dialysis, sudden cardiac death (SCD) accounts for 25-35% of all cardiovascular deaths. The objective was to determine if rare genetic variants known to be associated with cardiovascular death in the general population are associated with SCD in patients undergoing hemodialysis. METHODS We performed a case-control study comparing 126 (37 African American [AfAn] and 89 European ancestry [EA]) SCD subjects and 107 controls (34 AfAn and 73 EA), matched for age, sex, self-reported race, dialysis duration (<2, 2-5 and >5 years), and the presence or absence of diabetes mellitus. To target the coding regions of genes previously reported to be associated with 15 inherited cardiac conditions (ICCs), we used the TruSight Cardio Kit (Illumina, San Diego, CA, USA) to capture the genetic regions of interest. In all, the kit targets 572-kb regions that include the protein-coding regions and 40-bp 5' and 3' end-flanking regions of 174 genes associated with the 15 ICCs. Using the sequence data, burden tests were conducted to identify genes with an increased number of variants among SCD cases compared to matched controls. RESULTS Eleven genes were associated with SCD, but after correction for multiple testing, none of the 174 genes were identified as having more variants in the SCD cases than the matched controls, including previously identified genes. Secondary burden tests grouping variants based on diseases and gene function did not produce statistically significant associations. DISCUSSION/CONCLUSIONS We found no associations between genes known to be associated with ICCs and SCD in our sample of patients undergoing hemodialysis. This suggests that genetic causes are unlikely to be a major pathogenic factor in SCD in hemodialysis patients, although our sample size limits definitive conclusions.
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Affiliation(s)
- Tae-Hwi Schwantes-An
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, IN, USA
| | - Matteo Vatta
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, IN, USA
| | - Marco Abreu
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, IN, USA
| | - Leah Wetherill
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, IN, USA
| | - Howard J. Edenberg
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, IN, USA
- Department of Biochemistry and Molecular Biology, Indiana University School of Medicine, IN, USA
| | - Tatiana M. Foroud
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, IN, USA
| | - Glenn M. Chertow
- Stanford University Department of Medicine, Division of Nephrology, Stanford, CA, USA
| | - Sharon M. Moe
- Department of Medicine, Division of Nephrology and Hypertension, Indianapolis, IN, USA
- Department of Medicine, Roudebush Veterans Administration Medical Center, Indianapolis, IN, USA
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Poulikakos D, Hnatkova K, Skampardoni S, Green D, Kalra P, Malik M. Sudden Cardiac Death in Dialysis: Arrhythmic Mechanisms and the Value of Non-invasive Electrophysiology. Front Physiol 2019; 10:144. [PMID: 30873044 PMCID: PMC6401645 DOI: 10.3389/fphys.2019.00144] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2018] [Accepted: 02/07/2019] [Indexed: 01/10/2023] Open
Abstract
Sudden Cardiac Death (SCD) is the leading cause of cardiovascular death in dialysis patients. This review discusses potential underlying arrhythmic mechanisms of SCD in the dialysis population. It examines recent evidence from studies using implantable loop recorders and from electrophysiological studies in experimental animal models of chronic kidney disease. The review summarizes advances in the field of non-invasive electrophysiology for risk prediction in dialysis patients focusing on the predictive value of the QRS-T angle and of the assessments of autonomic imbalance by means of heart rate variability analysis. Future research directions in non-invasive electrophysiology are identified to advance the understanding of the arrhythmic mechanisms. A suggestion is made of incorporation of non-invasive electrophysiology procedures into clinical practice. Key Concepts: - Large prospective studies in dialysis patients with continuous ECG monitoring are required to clarify the underlying arrhythmic mechanisms of SCD in dialysis patients. - Obstructive sleep apnoea may be associated with brady-arrhythmias in dialysis patients. Studies are needed to elucidate the burden and impact of sleeping disorders on arrhythmic complications in dialysis patients. - The QRS-T angle has the potential to be used as a descriptor of uremic cardiomyopathy. - The QRS-T angle can be calculated from routine collected surface ECGs. Multicenter collaboration is required to establish best methodological approach and normal values. - Heart Rate Variability provides indirect assessment of cardiac modulation that may be relevant for cardiac risk prediction in dialysis patients. Short-term recordings with autonomic provocations are likely to overcome the limitations of out of hospital 24-h recordings and should be prospectively assessed.
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Affiliation(s)
- Dimitrios Poulikakos
- Renal Department, Salford Royal NHS Foundation Trust, Salford, United Kingdom
- Centre for Cardiac Research, Institute of Cardiovascular Sciences, The University of Manchester, Manchester, United Kingdom
| | - Katerina Hnatkova
- National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Sofia Skampardoni
- Renal Department, Salford Royal NHS Foundation Trust, Salford, United Kingdom
- Centre for Cardiac Research, Institute of Cardiovascular Sciences, The University of Manchester, Manchester, United Kingdom
| | - Darren Green
- Renal Department, Salford Royal NHS Foundation Trust, Salford, United Kingdom
- Centre for Cardiac Research, Institute of Cardiovascular Sciences, The University of Manchester, Manchester, United Kingdom
| | - Philip Kalra
- Renal Department, Salford Royal NHS Foundation Trust, Salford, United Kingdom
- Centre for Cardiac Research, Institute of Cardiovascular Sciences, The University of Manchester, Manchester, United Kingdom
| | - Marek Malik
- National Heart and Lung Institute, Imperial College London, London, United Kingdom
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Fu L, Zhou Q, Zhu W, Lin H, Ding Y, Shen Y, Hu J, Hong K. Do Implantable Cardioverter Defibrillators Reduce Mortality in Patients With Chronic Kidney Disease at All Stages? Int Heart J 2017; 58:371-377. [PMID: 28539571 DOI: 10.1536/ihj.16-357] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/09/2024]
Abstract
The benefits of implantable cardioverter defibrillator (ICD) implantation in chronic kidney disease (CKD) patients with high sudden cardiac death (SCD) risk are uncertain. To clarify the effects of receiving an ICD in CKD patients, we conducted this meta-analysis to identify the effects of ICDs on patients with CKD, including those on dialysis. We searched the Cochrane library, EMBASE, PubMed, and clinical trials for studies published before July 2016. Eleven studies including 20,196 CKD patients were considered for inclusion. The pooled analysis suggested that patients with an estimated glomerular filtration rate (eGFR) < 60 mL/minute/1.73 m2 would benefit from receiving treatments with ICDs compared with patients without an ICD device (aHR = 0.74; 95% confidence interval [CI], 0.63 to 0.86). [corrected]. This is the first report of a subgroup analysis on the survival rate of ICD implantation in CKD patients according to an eGFR group. The subgroup analysis indicated a similar protective association of ICDs in stage 3 (aHR = 0.71; 95% CI, 0.61 to 0.82) and 5 (aHR = 0.71; 95% CI, 0.54 to 0.92) CKD patients [corrected] compared with the control group. However, there was no significant improvement in all-cause mortality in stage 4 CKD patients (aHR = 1.02; 95%CI, 0.75 to 1.37) [corrected]. This is the first meta-analysis reporting that ICD implantation reduces all-cause mortality in stage 3 and 5 [corrected] CKD patients. However, the data do not indicate there is any benefit to ICD implantation in stage 4 [corrected] CKD patients.
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MESH Headings
- Death, Sudden, Cardiac/epidemiology
- Death, Sudden, Cardiac/etiology
- Death, Sudden, Cardiac/prevention & control
- Defibrillators, Implantable
- Global Health
- Humans
- Incidence
- Registries
- Renal Insufficiency, Chronic/complications
- Renal Insufficiency, Chronic/diagnosis
- Renal Insufficiency, Chronic/mortality
- Risk Assessment
- Risk Factors
- Survival Rate/trends
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Affiliation(s)
- Linghua Fu
- Department of Cardiovascular Medicine, the Second Affiliated Hospital of Nanchang University
| | - Qiongqiong Zhou
- Department of Cardiovascular Medicine, the Second Affiliated Hospital of Nanchang University
| | - Wengen Zhu
- Department of Cardiovascular Medicine, the Second Affiliated Hospital of Nanchang University
| | - Huang Lin
- Department of Cardiovascular Medicine, the Second Affiliated Hospital of Nanchang University
| | - Ying Ding
- Department of Cardiovascular Medicine, the Second Affiliated Hospital of Nanchang University
| | - Yang Shen
- Department of Cardiovascular Medicine, the Second Affiliated Hospital of Nanchang University
| | - Jinzhu Hu
- Department of Cardiovascular Medicine, the Second Affiliated Hospital of Nanchang University
| | - Kui Hong
- Department of Cardiovascular Medicine, the Second Affiliated Hospital of Nanchang University
- Jiangxi Key Laboratory of Molecular Medicine
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Makar MS, Pun PH. Sudden Cardiac Death Among Hemodialysis Patients. Am J Kidney Dis 2017; 69:684-695. [PMID: 28223004 DOI: 10.1053/j.ajkd.2016.12.006] [Citation(s) in RCA: 89] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Accepted: 12/12/2016] [Indexed: 02/07/2023]
Abstract
Hemodialysis patients carry a large burden of cardiovascular disease; most onerous is the high risk for sudden cardiac death. Defining sudden cardiac death among hemodialysis patients and understanding its pathogenesis are challenging, but inferences from the existing literature reveal differences between sudden cardiac death among hemodialysis patients and the general population. Vascular calcifications and left ventricular hypertrophy may play a role in the pathophysiology of sudden cardiac death, whereas traditional cardiovascular risk factors seem to have a more muted effect. Arrhythmic triggers also differ in this group as compared to the general population, with some arising uniquely from the hemodialysis procedure. Combined, these factors may alter the types of terminal arrhythmias that lead to sudden cardiac death among hemodialysis patients, having important implications for prevention strategies. This review highlights current knowledge on the epidemiology, pathophysiology, and risk factors for sudden cardiac death among hemodialysis patients. We then examine strategies for prevention, including the use of specific cardiac medications and device-based therapies such as implantable defibrillators. We also discuss dialysis-specific prevention strategies, including minimizing exposure to low potassium and calcium dialysate concentrations, extending dialysis treatment times or adding sessions to avoid rapid ultrafiltration, and lowering dialysate temperature.
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Affiliation(s)
- Melissa S Makar
- Duke Clinical Research Institute, Durham, NC; Division of Nephrology, Department of Medicine, Duke University School of Medicine, Durham, NC.
| | - Patrick H Pun
- Duke Clinical Research Institute, Durham, NC; Division of Nephrology, Department of Medicine, Duke University School of Medicine, Durham, NC
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Nigwekar SU, Zhao S, Wenger J, Hymes JL, Maddux FW, Thadhani RI, Chan KE. A Nationally Representative Study of Calcific Uremic Arteriolopathy Risk Factors. J Am Soc Nephrol 2016; 27:3421-3429. [PMID: 27080977 PMCID: PMC5084892 DOI: 10.1681/asn.2015091065] [Citation(s) in RCA: 124] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2015] [Accepted: 03/14/2016] [Indexed: 11/03/2022] Open
Abstract
Accurate identification of risk factors for calcific uremic arteriolopathy (CUA) is necessary to develop preventive strategies for this morbid disease. We investigated whether baseline factors recorded at hemodialysis initiation would identify patients at risk for future CUA in a matched case-control study using data from a large dialysis organization. Hemodialysis patients with newly diagnosed CUA (n=1030) between January 1, 2010, and December 31, 2014, were matched by age, sex, and race in a 1:2 ratio to hemodialysis patients without CUA (n=2060). Mean ages for patients and controls were 54 and 55 years, respectively; 67% of participants were women and 49% were white. Median duration between hemodialysis initiation and subsequent CUA development was 925 days (interquartile range, 273-2185 days). In multivariable conditional logistic regression analyses, diabetes mellitus; higher body mass index; higher levels of serum calcium, phosphorous, and parathyroid hormone; and nutritional vitamin D, cinacalcet, and warfarin treatments were associated with increased odds of subsequent CUA development. Compared with patients with diabetes receiving no insulin injections, those receiving insulin injections had a dose-response increase in the odds of CUA involving lower abdomen and/or upper thigh areas (odds ratio, 1.49; 95% confidence interval, 1.03 to 2.51 for one or two injections per day; odds ratio, 1.88; 95% confidence interval, 1.30 to 3.43 for 3 injections per day; odds ratio, 3.74; 95% confidence interval, 2.28 to 6.25 for more than three injections per day), suggesting a dose-effect relationship between recurrent skin trauma and CUA risk. The presence of risk factors months to years before CUA development observed in this study will direct the design of preventive strategies and inform CUA pathobiology.
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Affiliation(s)
- Sagar U Nigwekar
- Division of Nephrology, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts;
| | - Sophia Zhao
- Division of Nephrology, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts
| | - Julia Wenger
- Division of Nephrology, University of North Carolina Kidney Center, Chapel Hill, North Carolina; and
| | - Jeffrey L Hymes
- Medical office, Fresenius Medical Care North America, Waltham, Massachusetts
| | - Franklin W Maddux
- Medical office, Fresenius Medical Care North America, Waltham, Massachusetts
| | - Ravi I Thadhani
- Division of Nephrology, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts
| | - Kevin E Chan
- Division of Nephrology, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts
- Medical office, Fresenius Medical Care North America, Waltham, Massachusetts
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7
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Charytan DM, Foley R, McCullough PA, Rogers JD, Zimetbaum P, Herzog CA, Tumlin JA. Arrhythmia and Sudden Death in Hemodialysis Patients: Protocol and Baseline Characteristics of the Monitoring in Dialysis Study. Clin J Am Soc Nephrol 2016; 11:721-34. [PMID: 26763255 DOI: 10.2215/cjn.09350915] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Dialysis patients have high rates of cardiovascular morbidity and mortality, but data on arrhythmia burden, arrhythmia type, arrhythmia triggers, and the identity of terminal arrhythmias have historically been limited by an inability to monitor heart rhythm for prolonged periods. OBJECTIVES To investigate arrhythmia and its association with sudden death in dialysis-dependent ESRD, describe the potential for implantable devices to advance study of dialysis physiology, review the ethical implications of using implantable devices in clinical studies, and report on the protocol and baseline results of the Monitoring in Dialysis Study (MiD). DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS In this multicenter, interventional-observational, prospective cohort study, we placed implantable loop recorders in patients undergoing long-term hemodialysis. The proportion of patients experiencing clinically significant arrhythmias was the primary endpoint. For 6 months, we captured detailed data on the primary endpoint, symptomatic arrhythmias, other electrocardiographic variables, dialysis prescription, electrolytes, dialysis-related variables, and vital signs. We collected additional electrocardiographic data for up to 1 year. RESULTS Overall, 66 patients underwent implantation in sites in the United States and India. Diabetes was present in 63.6% of patients, 12.1% were age ≥70 years, 69.7% were men, and 53.0% were black. Primary and secondary endpoint data are expected in 2016. CONCLUSIONS Cardiac arrhythmia is an important contributor to cardiovascular morbidity and mortality in dialysis patients, but available technology has previously limited the ability to estimate its true burden and triggers and to define terminal rhythms in sudden death. Use of implantable technology in observational studies raises complex issues but may greatly expand understanding of dialysis physiology. The use of implantable loop recorders in MiD is among the first examples of such a trial, and the results are expected to provide novel insights into the nature of arrhythmia in hemodialysis patients.
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Affiliation(s)
- David M Charytan
- Department of Medicine, Brigham & Women's Hospital, Boston, Massachusetts;
| | - Robert Foley
- Department of Medicine, Hennepin County Medical Center, University of Minnesota, Minneapolis, Minnesota
| | - Peter A McCullough
- Department of Medicine, Baylor University Medical Center, Baylor Heart and Vascular Institute, Baylor Jack and Jane Hamilton Heart and Vascular Hospital, Dallas, Texas; Department of Medicine, Division of Cardiology, The Heart Hospital, Plano, Texas
| | - John D Rogers
- Department of Cardiology, Scripps Clinic, Torrey Pines, California
| | - Peter Zimetbaum
- Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts; and
| | - Charles A Herzog
- Department of Medicine, Hennepin County Medical Center, University of Minnesota, Minneapolis, Minnesota
| | - James A Tumlin
- Department of Medicine, University of Tennessee, Chattanooga College of Medicine, Chattanooga, Tennessee
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Luque Y, Bataille A, Taldir G, Rondeau É, Ridel C. [Cardiac arrest in dialysis patients: Risk factors, preventive measures and management in 2015]. Nephrol Ther 2015; 12:6-17. [PMID: 26547563 DOI: 10.1016/j.nephro.2015.06.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Revised: 06/29/2015] [Accepted: 06/30/2015] [Indexed: 02/06/2023]
Abstract
Patients undergoing hemodialysis have a 10 to 20 times higher risk of sudden cardiac arrest (SCA) than the general population. Sudden cardiac death is a rare event (approximately 1 event per 10,000 sessions) but has a very high mortality rate. Epidemiological data comes almost exclusively from North American studies; there is a great lack of European data on the subject. Ventricular arrhythmia is the main mechanism of sudden cardiac deaths in dialysis patients. These patients develop increased sensitivity mainly due to a high prevalence of severe ischemic heart disease and left ventricular hypertrophy and to a frequent trigger event: electrolytic and plasma volume shifts during dialysis sessions. Unfortunately, accurate predictive markers of SCA do not exist, however some primary prevention trials using beta-blockers or angiotensin II receptor blockers are encouraging, while the use of implantable cardioverter defibrillators in the population of chronic dialysis patients remains controversial. Identification of patients at risk, minimizing trigger events such as electrolytic shifts and improving team skills in the diagnosis and initial resuscitation with the latest recommendations from 2010 seem necessary to reduce incidence and improve survival in this high risk population. Organization of European studies would also allow a more accurate view of this reality in our dialysis units.
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Affiliation(s)
- Yosu Luque
- Service des urgences néphrologiques et de transplantation rénale, hôpital Tenon, 4, rue de la Chine, 75571 Paris cedex 20, France; Inserm UMR S 1155, bâtiment recherche, hôpital Tenon, 4, rue de la Chine, 75020 Paris, France.
| | - Aurélien Bataille
- Département d'anesthésie-réanimation, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75010 Paris, France; Inserm UMR S 1155, bâtiment recherche, hôpital Tenon, 4, rue de la Chine, 75020 Paris, France
| | - Guillaume Taldir
- Service de cardiologie, centre hospitalier de Saint-Brieuc, 22027 Saint-Brieuc cedex 1, France
| | - Éric Rondeau
- Service des urgences néphrologiques et de transplantation rénale, hôpital Tenon, 4, rue de la Chine, 75571 Paris cedex 20, France; Inserm UMR S 1155, bâtiment recherche, hôpital Tenon, 4, rue de la Chine, 75020 Paris, France; Sorbonne universités, UPMC université Paris 06, 4, place Jussieu, 75005 Paris, France
| | - Christophe Ridel
- Service dialyse et aphérèse Aura Paris Plaisance, 185A, rue Raymond-Losserand, 75014 Paris, France
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