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CKD and sudden cardiac death: epidemiology, mechanisms, and therapeutic approaches

Isaac R Whitman1, Harold I Feldman, Rajat Deo

  • 1Department of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.

Journal of the American Society of Nephrology : JASN
|October 27, 2012
PubMed

Insights

Chronic kidney disease (CKD) significantly increases cardiovascular risks, including sudden cardiac death. This review highlights new findings on arrhythmias and prevention strategies for CKD patients.

Area of Science:

  • Nephrology
  • Cardiology
  • Clinical Research

Background:

  • Chronic kidney disease (CKD) is independently associated with increased cardiovascular mortality, heart failure, and myocardial infarction.
  • Emerging evidence links CKD to a broader range of adverse cardiovascular outcomes, notably ventricular arrhythmias and sudden cardiac death.

Purpose of the Study:

  • To review recent clinical studies on the association between CKD and ventricular arrhythmias/sudden cardiac death.
  • To explore experimental data on cardiac structural and electrophysiologic changes in CKD.
  • To discuss current and future therapeutic strategies for preventing sudden cardiac death in CKD patients.

Main Methods:

  • Review of recent clinical studies and experimental models.
  • Analysis of data on cardiac remodeling and electrophysiologic alterations in CKD.
  • Evaluation of evidence for pharmacologic and device-based prevention therapies.

Main Results:

  • CKD is linked to ventricular arrhythmias and sudden cardiac death.
  • Experimental models show structural and electrophysiologic heart changes in CKD.
  • These changes may underlie the elevated arrhythmic risk.

Conclusions:

  • CKD patients face a heightened risk of sudden cardiac death due to cardiac remodeling and electrophysiologic changes.
  • Pharmacologic and device-based therapies offer potential for primary and secondary prevention of sudden cardiac death in CKD.
  • Further research is needed to optimize risk stratification and therapeutic interventions.

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