The current status of interventions aiming at reducing sudden cardiac death in dialysis patients

• Published in: European heart journal 2009-07, Vol.30 (13), p.1559-1564
• Main Authors: de Bie, Mihály K., van Dam, Bastiaan, Gaasbeek, André, van Buren, Marjolijn, van Erven, Lieselot, Bax, Jeroen J., Schalij, Martin J., Rabelink, Ton J., Jukema, J. Wouter
• Format: Article
• Language: English
• Subjects: Adrenergic beta-Antagonists - therapeutic use; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Cardiology. Vascular system; Coronary heart disease; Death, Sudden, Cardiac - epidemiology; Death, Sudden, Cardiac - etiology; Death, Sudden, Cardiac - prevention & control; Defibrillators, Implantable; Dialysis; Emergency and intensive care: neonates and children. Prematurity. Sudden death; Erythropoietin - therapeutic use; Heart; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use; Implantable cardioverter defibrillator therapy; Intensive care medicine; Ischaemic heart disease; Kidney Failure, Chronic - complications; Kidney Failure, Chronic - therapy; Left ventricular hypertrophy; Medical sciences; Myocardial Revascularization; Myocarditis. Cardiomyopathies; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Recombinant Proteins; Renal Dialysis - adverse effects; Renal Dialysis - methods; Renal Dialysis - mortality; Risk Factors; Sudden cardiac death
• ISSN: 0195-668X; 1522-9645
• DOI: 10.1093/eurheartj/ehp185

Mortality in dialysis patients is extremely high, with an annual death rate of ∼23%. Sudden cardiac death (SCD) is the single largest cause of death in dialysis patients accounting for ∼60% of all cardiac deaths and 25% of all-cause mortality. Interventions aiming at reducing cardiovascular mortality, especially SCD, in dialysis patients are therefore extremely important and clinically highly relevant. The purpose of this review is to give an outline of the epidemiology of SCD in dialysis patients and to provide a comprehensive overview of several interventional strategies (medical therapies, changing dialysis modality, and revascularization). Furthermore, it will discuss the current knowledge regarding the value of preventive implantable cardioverter defibrillator implantation and address future implications of the interventional strategies mentioned.