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Sudden death in incident dialysis patients
Eduardo Vázquez1, Carmen Sánchez-Perales, Francisco García-García
1Department of Cardiology, Complejo Hospitalario de Jaén, Jaén, Spain.
American Journal of Nephrology
|April 23, 2014
Summary
Sudden death (SD) is frequent in dialysis patients. Previous myocardial infarction and electrocardiographic abnormalities are key predictors of sudden death within 24 hours and 1 hour of symptom onset.
Area of Science:
- Nephrology
- Cardiology
- Public Health
Background:
- Sudden death (SD) is a major cause of mortality, particularly in patients with cardiovascular diseases.
- Dialysis patients face a high prevalence of cardiovascular issues, making SD a significant healthcare concern.
Purpose of the Study:
- To retrospectively analyze the incidence of sudden death (SD) in patients initiating dialysis.
- To identify factors associated with the occurrence of SD in this patient population.
Main Methods:
- A cohort of 285 patients commencing dialysis between November 2003 and September 2007 was evaluated.
- Follow-up extended until December 2012, recording deaths, transplants, or study completion.
- Sudden death was defined as occurring within 24 hours (SD 24H) or 1 hour (SD 1H) of symptom onset.
Main Results:
- Over 947 patient-years, 168 deaths (59%) occurred. 10% experienced SD 24H and 6% experienced SD 1H.
- Multivariate analysis identified prior myocardial infarction and electrocardiographic abnormalities (Q wave, negative T wave, subendocardial lesion, QRS >120 ms) as independent predictors.
- These factors significantly increased the odds of SD 24H (OR 7.83) and SD 1H (OR 13.43).
Conclusions:
- Sudden death is a frequent event in patients undergoing dialysis.
- Distinct patient groups with clearly differentiated risk profiles for sudden death can be identified.
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