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Title: Patients on Dialysis Have a Significantly Higher Risk of Sudden Cardiac Death
URL: http://www.pslgroup.com/dg/2313F2.htm
Doctor's Guide
October 22, 2008

BALTIMORE, Md -- October 22, 2008 -- In a 10-year study of more than a thousand kidney failure patients, sudden cardiac death emerged as the number one cause of death for patients on dialysis. The study is published early online and appearing in the November 2 issue of Kidney International.

The authors identified systemic inflammatory response and malnutrition as key risk factors for the fatal heart attacks.

"This is believed to be the first time anyone has taken a rigorous prospective look at why so many patients on dialysis die from sudden cardiac death, and the results could help doctors identify those at highest risk and potentially save lives," said Rulan S. Parekh, MD, Department of Nephrology, Johns Hopkins University School of Medicine, Baltimore, Maryland.

Dr. Parekh and colleagues gathered data from the Choices for Healthy Outcomes in Caring for ESRD (CHOICE) cohort of 1,041 end-stage renal disease (ESRD) patients on dialysis. In a 9.5 year period, 658 of this group died. Of these 146 died as a result of sudden cardiac death (SCD).

The researchers then looked at previously recorded blood test results from 122 of the 146 SCD patients to search for a possible relationship between the deaths and levels of high-sensitivity C-reactive (hsCRP), interlukin-6 (IL-6) and albumin.

Results showed that patients with high levels of either hsCRP or IL-6 were twice as likely to die from SCD as those with low levels of these proteins. Low albumin levels were associated with a 1.35 times increase in the risk of dying of SCD when compared with high levels.

In addition, those with low levels of albumin and high levels of hsCRP were 4 times more likely to die of SCD than those with high levels and albumin and low levels of hsCRP.

"These results tell us that ESRD patients with low albumin and/or high levels of IL-6 and hsCRP are at a significantly higher risk of SCD," said Dr. Parekh.

"When people think of heart attacks, they think of cholesterol and obesity, but these are risk factors for hardening of the arteries and are not directly linked to sudden heart death among patients on dialysis."

SOURCE: Johns Hopkins Medicine

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