| Modifiable risk factors associated with sudden cardiac arrest within hemodialysis clinics. | |
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MedLine Citation:
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PMID: 20811332 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Sudden cardiac arrest is the most common cause of death among patients with end-stage kidney disease (ESKD) maintained on hemodialysis. Here we sought to identify dialysis-related factors associated with this increased risk in a case-control study encompassing 43,200 patients dialyzed in outpatient clinics of a large organization. Within this group, we compared the clinical and dialysis-specific data of 502 patients who experienced a sudden cardiac arrest with 1632 age- and dialysis-vintage-matched controls. There were 4.5 sudden cardiac arrest events per 100,000 dialysis treatments during the 3-year study period. These patients were significantly more likely to have been exposed to low potassium dialysate of less than 2 meq/l. These differences could not be explained by predialysis serum potassium levels. There was no evidence for a beneficial effect of low potassium dialysate even among those with higher predialysis serum potassium levels. Other factors strongly associated with sudden cardiac arrest by multivariable analysis included increased ultrafiltration volumes, exposure to low calcium dialysate, and predialysis serum creatinine levels. These relationships persisted after adjustment for covariates, but traditional risk factors such as history of coronary heart disease and congestive heart failure were not significantly influential. Hence, our study suggests that modifications of the hemodialysis prescription may improve the risk of sudden cardiac arrest in patients with ESKD. |
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Authors:
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Patrick H Pun; Ruediger W Lehrich; Emily F Honeycutt; Charles A Herzog; John P Middleton |
Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't Date: 2010-09-01 |
Journal Detail:
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Title: Kidney international Volume: 79 ISSN: 1523-1755 ISO Abbreviation: Kidney Int. Publication Date: 2011 Jan |
Date Detail:
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Created Date: 2010-12-30 Completed Date: 2011-04-27 Revised Date: 2011-06-29 |
Medline Journal Info:
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Nlm Unique ID: 0323470 Medline TA: Kidney Int Country: United States |
Other Details:
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Languages: eng Pagination: 218-27 Citation Subset: IM |
Affiliation:
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Duke University Medical Center, Division of Nephrology, Department of Medicine, Durham, North Carolina, USA. patrick.pun@duke.edu |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged Ambulatory Care Facilities Case-Control Studies Death, Sudden, Cardiac / etiology*, prevention & control* Female Hemodialysis Solutions / analysis Humans Kidney Failure, Chronic / blood, therapy Male Middle Aged Multivariate Analysis Potassium / analysis, blood Renal Dialysis / adverse effects* Risk Factors |
| Grant Support | |
ID/Acronym/Agency:
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1KL2-RR-024127-01/RR/NCRR NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Hemodialysis Solutions; 7440-09-7/Potassium |
| Comments/Corrections | |
Comment In:
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Kidney Int. 2011 Jan;79(2):147-9
[PMID:
21191388
]
Kidney Int. 2011 Jun;79(11):1259 [PMID: 21566639 ] |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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