Prevention of Sudden Cardiac Death in Hemodialysis Patients

ISSN: 2212-4063 (Online)
ISSN: 1871-529X (Print)

Volume 17, 3 Issues, 2017

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Cardiovascular & Hematological Disorders-Drug Targets

Formerly: Current Drug Targets - Cardiovascular & Hematological Disorders

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Garry X. Shen
University of Manitoba
Winnipeg, MB

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Prevention of Sudden Cardiac Death in Hemodialysis Patients

Cardiovascular & Hematological Disorders-Drug Targets, 14(3): 195-204.

Author(s): Michelle M. O’Shaughnessy, John A. O’Regan and Peter J Lavin.

Affiliation: Trinity Health Kidney Centre, Tallaght Hospital, Trinity College, Dublin, Ireland.


One quarter of all hemodialysis patients will succumb to sudden cardiac death (SCD), a rate far exceeding that observed in the general population. A high prevalence of atherosclerotic coronary artery disease amongst patients with end-stage kidney disease (ESKD) partly explains this exaggerated risk. However, uremia and dialysis related factors are also of critical importance.

Interventions aimed at preventing SCD have been inadequately studied in patients with ESKD. Data extrapolated from non-renal populations cannot necessarily be applied to hemodialysis patients, who possess relatively unique risk factors for SCD including “uremic cardiomyopathy”, electrolyte shifts, fluctuations in intravascular volume and derangements of mineral and bone metabolism.

Pending data derived from proposed randomized controlled clinical trials, critical appraisal of existing evidence and the selective application of guidelines developed for the general population to dialysis patients are required if therapeutic nihilism, or excessive intervention, are to be avoided. We discuss the evidence supporting a role for medical therapies, dialysis prescription refinements, revascularization procedures and electrical therapies as potential interventions to prevent SCD amongst hemodialysis patients. Based on current best available evidence, we present suggested strategies for the prevention of arrhythmia-mediated death in this highly vulnerable patient population.


Arrhythmia, defibrillator, dialysis, end-stage kidney disease, hemodialysis, prevention, sudden cardiac death.

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Article Details

Volume: 14
Issue Number: 3
First Page: 195
Last Page: 204
Page Count: 10
DOI: 10.2174/1871529X14666140401112956
Price: $58

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