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Sudden Cardiac Death and Arrhythmia in CKD

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Cardio-Renal Clinical Challenges

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Abstract

Sudden cardiac death (SCD) is defined as unexpected natural death from cardiac causes within 1 h of sudden loss of consciousness. It was the leading cause of death in hemodialysis patients in the USA, accounting for 26 % of all cause mortality. The very high rate of cardiovascular death and the substantial contribution of SCD to these rates in patients with CKD and ESRD is not fully explained by the high prevalence of traditional cardiac risk factors including hypertension, smoking, diabetes and dyslipidemia. Predisposing factors include the underlying cardiomyopathy, coronary artery disease, sympathetic overactivity, inflammation, abnormalities in mineral metabolism, and the dialysis prescription. Observational studies suggest that beta-blockers and renin angiotensin system blockage may prevent SCD, as may avoidance of low potassium dialysate. Management of mineral abnormalities may reduce the risk of death or cardiac events. Implantable cardiac defibrillation may be beneficial in selected patients.

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Authors and Affiliations

  1. Department of Nephrology, Health Sciences Center, Memorial University, 300 Prince Philip Drive, St. John’s, A1B 3 V6, NL, Canada

    Sean P. Martin BSc (Hons), MD & Patrick S. Parfrey MD, FRCPC, FRSC

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  1. Sean P. Martin BSc (Hons), MD
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  2. Patrick S. Parfrey MD, FRCPC, FRSC
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Correspondence to Patrick S. Parfrey MD, FRCPC, FRSC .

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Editors and Affiliations

  1. Renal and Transplantation Department, Guy's Hospital, London, United Kingdom

    David Goldsmith

  2. Gr. T. Popa University of Medicine and Pharmacy, Iasi, Romania

    Adrian Covic

  3. Karolinska Institutet Danderyd University Hospital, Stockholm, Sweden

    Jonas Spaak

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Martin, S.P., Parfrey, P.S. (2015). Sudden Cardiac Death and Arrhythmia in CKD. In: Goldsmith, D., Covic, A., Spaak, J. (eds) Cardio-Renal Clinical Challenges. Springer, Cham. https://doi.org/10.1007/978-3-319-09162-4_3

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