SUDDEN CARDIAC DEATH IN HEMODIALYSIS PATIENTS - ASSESSMENT OF RISK FACTORS AND PREVENTION

  • Dejan S Petrovic Univerzitet u Kragujevcu Fakultet medicinskih nauka
  • Jasna Trbojević-Stanković Department of Hemodialysis, Clinical Hospital Center "Dragiša Mišović", Belgrade
  • Vesna Stojanovic-Marjanovic Clinic for Internal Medicine, Clinical Center "Kragujevac", Kragujevac
  • Aleksandra Nikolic Clinic for Internal Medicine, Clinical Center "Kragujevac", Kragujevac
  • Vladimir Miloradovic Clinic for Cardiology, Clinical Center "Kragujevac", Kragujevac, Serbia
Keywords: Death, Sudden, Risk, Dialysis,

Abstract


Hemodialysis patients are at high risk for sudden cardiac death (SCD), with annual mortality rate from SCD ranging 5-7%. The risk factors for SCD on hemodialysis include: left ventricular remodeling, coronary disease, heart failure, rapid electrolyte and fluid shifts during dialysis sessions and secondary hyperparathyroidism. Ehocardiography and standard electrocardiography can help identify patients at risk for SCD. The strategy for preventing SCD in hemodialysis patients includes primary (medicamentous treatment and adjusting dialysis parameters) and secondary (coronary revascularization and placement of cardioverter defibrillator) treatment plan.

Author Biography

Dejan S Petrovic, Univerzitet u Kragujevcu Fakultet medicinskih nauka

KC Kragujevac

Klinika za nefrologiju i urologiju

Centar za nefrologiju i dijalizu

References

Green D, Roberts PR. Ventricular arrhythmias and sudden death in patients with chronic kidney disease. J Ren Care 2010; 36(Suppl 1): 54-60.

Herzog CA, Mangrum M, Passman R. Sudden Cardiac Death and Dialysis Patients. Semin Dial 2008; 21(4): 300-7.

Petrović D, Jagić N, Miloradović V, Stojimirović B. Non-tradicional risk factors for development of cardiovascular complications in haemodialysis patients. Ser J Exp Clin Res 2009; 10(3): 95-102. (in Serbian)

Chue CD, Townend JN, Steeds RP, Ferro CJ. Arterial stiffness in chronic kidney disease: causes and consequences. Heart 2010; 96(11): 817-23.

Shamseddin MK, Parfrey PS. Sudden cardiac death in chronic kidney disease: epidemiology and prevention. Nat Rev Nephrol 2011; 7(3): 145-54.

Petrović D, Miloradović V, Poskurica M, Stojimirović B. Diagnostics and treatment of ishemic heart disease in hemodialysis patients. Vojnosanit Pregl 2009; 66(11): 897-903. (in Serbian)

Petrović D, Stojimirović B. Secondary hyperparathyroidism - risk factor for development of cardiovascular complications in patients on hemodialysis. Med Pregl 2010; LXIII(9-10): 674-80. (in Serbian)

Petrović D, Stojimirović B. Left ventricular hypertrophy in hemodialysis patients. Med Pregl 2008; LXI(7-8): 369-74. (in Serbian)

Petrović D, Miloradović V, Poskurica M, Stojimirović B. Heart failure in haemodialysis patients: evaluation and treatment. Srp Arh Celok Lek 2011; 139(3-4): 248-55. (in Serbian)

Beumi M, Coppolino G, Bolignano D, Sturiale A, Campo S, Buemi A, et al. Arrhythmias and Hemodialysis: Role of Potassium and New Diagnostic Tools. Ren Fail 2009; 31(1): 75-80.

Severi S, Grandi E, Pes C, Badiali F, Grandi F, Santoro A. Calcium and potassium changes during haemodialysis alter ventricular repolarization: in vivo and in silico analysis. Nephrol Dial Transplant 2008; 23(4): 1378-86.

Genovesi S, Dossi C, ViganoMR, Galbiati E, Prolo F, Stella A, et al. Electrolyte concentration during haemodialysis and QT interval prolongation in uraemic patients. Europace 2008; 10(6): 771-7.

Pun PH, Lehrich RW, Honecycutt EF, Herzog CA, Middleton JP. Modifiable risk factors associated with sudden cardiac arrest within hemodialysis clinics. Kidney Int 2011; 79(2): 218-27.

Santoro A. Cardiovascular dialysis instability and convective therapies. Hemodialysis Int 2006; 10(1): 51-5.

Burton JO, Korsheed S, Grundy BJ, McIntyre CW. Hemodialysis-Induced Left Ventricular Dysfunction Is Associated with an Increase in Ventricular Arrhythmias. Ren Fail 2008; 30(7): 701-9.

Lopez-Gomez JM, Villaverde M, Jofre R, et al. Interdialytic weight gain as a marker of blood pressure, nutrition, and survival in hemodialysis patients. Kidney Int 2005; 67(Suppl 93): 63-8.

Petrović D, Stojimirović B. Cardiovascular morbidity and mortality in hemodialysis patients - epidemiological analysis. Vojnosanit Pregl 2008; 65(12): 893-900. (in Serbian)

Petrović D, Obrenović R, Trbojević-Stanković J, Majkić-Singh N, Stojimirović B. Cardiovascular mortality in hemodialysis patients: clinical and epidemiological analysis. J Med Biochem 2011; 30(4): 302-8. (in Serbian)

Petrović D, Obrenović R, Trbojević-Stanković J, Majkić-Singh N, Stojimirović B. Hyperphosphatemia - the risk factor dor adverse outcome in maintenance hemodialysis patients. J Med Biochem 2012; 31(3): 239-45. (in Serbian)

Kanabay M, Afsar B, Goldsmith D, Covic A. Sudden Death in Hemodialysis: An Update. Blood Purif 2010; 30(2): 135-45.

Saravanan P, Davidson NC. Risk Assessment for Sudden Cardiac Death in Dialysis Patients. Circ Arrhythm Electrophysiol 2010; 3(5): 553-9.

Petrović D, Jagić N, Miloradović V, Stojimirović B. Clinical importance of biochemical markers of cardiac damage in hemodialysis patients. Ser J Exp Clin Res 2008; 9(1): 5-8. (in Serbian)

Petrović D, Stojimirović B. Cardiac troponins: outcome predictors in hemodialysis patients. J Artif Organs 2009; 12(4): 258-63.

Green D, Roberts PR, New DI, Kalra PA. Sudden Cardiac Death in Hemodialysis Patients: An In-Depth Review. Am J Kidney Dis 2011; 57(6): 921-9.

Gussak I, Gussak HM. Sudden cardiac death in nephrology: focus on acquired long QT syndrome. Nephrol Dial Transplant 2007; 22(1): 12-4.

Wu V-C, Lin L-Y, Wu K-D. QT interval dispersion in dialysis patients. Nephrology 2005; 10(2): 109-12.

Ranpuria R, Hall M, Chan CT, Unruh M. Heart rate variability (HRV) in kidney failure: measurement and consequence of reduced HRV. Nephrol Dial Transplant 2008; 23(2): 444-9.

Chan CT, Levin NW, Chertow GM, Larive B, Schulman G, Kotanko P, and the Frequent Hemodialysis Network Daily Trial Group. Determinants of Cardiac Autonomic Dysfunction in ESRD. Clin J Am Soc Nephrol 2010; 5(10): 1821-7.

Furgeson SB, Chonchol M. -Blockade in Chronic Dialysis Patients. Semin Dial 2008; 21(1): 43-8.

De Bie MK, van Dam B, Gaasbeek A, van Buren M, van Erven L, Bax JJ, et al. The current status of interventions aiming at reducing sudden cardiac death in dialysis patients. Eur Heart J 2009; 30(13): 1559-64.

Petrović D, Tirmenštajn-Janković B, Živanović M, Nikolić A, Poskurica M, Stojimirović B. Sudden cardiac death in patients on regular hemodialysis. Timoč Med Glas 2010; 35(1-2): 19-26. (in Serbian)

McCullough PA, Sandberg KR. Chronic Kidney Disease and Sudden Death: Strategies for Prevention. Blood Purif 2004; 22(1): 136-42.

Massy ZA, Kasiske BL. Prevention of cardiovascular complications in chronic renal disease. In: Cardiovascular Disease in End-stage Renal Failure. Loscalzo J, London GM, (eds). New York: The Oxford University Press; 2000: 463-81.

Cice G, Ferrara L, Benedetto AD, Russo PE, Marinelli G, Pavese F, et al. Dilated Cardiomyopathy in Dialysis-Benefical Effects of Carvedilol: A Double-Blind, Placebo-Controlled Trial. J Am Coll Cardiol 2001; 37(2): 407-11.

Cice G, Ferrara L, D,Andrea A, D,Isa S, Benedetto AD, Cittadini A, Russo PE, et al. Carvedilol Increases Two-Year Survival in Dialysis Patients With Dilated Cardiomyopathy. J Am Coll Cardiol 2003; 41(9): 1438-44.

Herzog CA. Can We Prevent Sudden cardiac Death in Dialysis Patients? Clin J Am Soc Nephrol 2007; 2(3): 410-2.

Karkar A. Caring for Patients with CRF: Rewards and Benefits. Int J Nephrol 2011: ID 639840.

Sood MM, Pauly RP, Rigatto C, Komenda P. Left ventricular dysfunction in the haemodialysis population. NDT Plus 2008; 1(4): 199-205.

Williams ME. Coronary Revascularisation in Diabetic Chronic Kidney Disease/End-Stage Renal Disease: A Nephrologists perspective. Clin J Am Soc Nephrol 2006; 1(2): 209-20.

Johnston N, Dargie H, Jardine A. Diagnosis and treatment of coronary artery disease in patients with chronic kidney disease. Heart 2008; 94(8): 1080-8.

Rahmanian PB, Adams DH, Castillo JG, Vassalotti J, Filsoufi F. Early and late outcome of cardiac surgery in dialysis-dependent patients: Single-center experience with 245 consecutive patients. J Thorac Cardiovasc Surg 2008; 135(4): 915-22.

Nevis IF, Mathew A, Novick RJ, Parikh CR, Devereaux PJ, Natarajan MK, Iansavichus AV, et al. Optimal Method of Coronary Revascularisation in Patients Receiving Dialysis: Systematic Review. Clin J Am Soc Nephrol 2009; 4(2): 369-78.

Ito I, Kono K, Shinbo G, Tadokoro K, Abe C, Takemura N, et al. Implantable cardioverter defibrillator in maintenance hemodialysis patients with ventricular tachyarrhythmias: A single-center experience. Hemodialysis Int 2009; 13(1): 48-54.

Korantzopoulos P, Liu T, Li L, Goudevenos JA, Li G. Implantable cardioverter defibrillator therapy in chronic kidney disease: a meta-analysis. Europace 2009; 11(11): 1469-75.

Roberts PR, Green D. Arrhythmias in chronic kidney disease. Heart 2011; 97(9): 766-73.

Kanbay M, Solak Y, Covic A, Goldsmith D. Sudden Cardiac Death in Patients with Chronic Kidney Disease: Prevention Is the sine qua non. Kidney Blood Press Res 2011; 34(4): 269-76.

Janković SM. Rituximab for the treatment of rheumatiod arthritis patients with failure to the first biologic drug: Impact on Republic fund for health insurance in Serbia. Racionalna terapija 2013; 5(1):1-7.

Published
2013/06/24
Section
Professional Paper