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Sudden cardiac death in hemodialysis patients: a comprehensive care approach to reduce risk.

Publication ,  Journal Article
Pun, PH; Middleton, JP
Published in: Blood Purif
2012

Sudden cardiac death is a major problem in hemodialysis patients, and our understanding of this disease is underdeveloped. The lack of a precise definition tailored for use in the hemodialysis population limits the reliability of epidemiologic reports. Efforts should be directed toward an accurate classification of all deaths that occur in this vulnerable population. The traditional paradigm of disease pathophysiology based on known cardiac risk factors appears to be inadequate to explain the magnitude of sudden cardiac death risk in chronic kidney disease, and numerous unique cofactors and exposures appear to determine risk in this population. Well-designed cohort studies will be needed for a basic understanding of disease pathophysiology and risk factors, and randomized intervention trials will be needed before best management practices can be implemented. This review examines available data to describe the characteristics of the high-risk patient and suggests a comprehensive common sense approach to prevention using existing cardiovascular medications and reducing and monitoring potential dialysis-related arrhythmic triggers. Other unproven cardiovascular therapies such as implantable cardioverter defibrillators should be used on a case-by-case basis, with recognition of the associated hazards that these devices carry among hemodialysis patients.

Duke Scholars

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Published In

Blood Purif

DOI

EISSN

1421-9735

Publication Date

2012

Volume

33

Issue

1-3

Start / End Page

183 / 189

Location

Switzerland

Related Subject Headings

  • Urology & Nephrology
  • Risk Factors
  • Renal Dialysis
  • Kidney Failure, Chronic
  • Humans
  • Defibrillators, Implantable
  • Death, Sudden, Cardiac
  • Comprehensive Health Care
  • 3202 Clinical sciences
  • 1103 Clinical Sciences
 

Citation

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Pun, P. H., & Middleton, J. P. (2012). Sudden cardiac death in hemodialysis patients: a comprehensive care approach to reduce risk. Blood Purif, 33(1–3), 183–189. https://doi.org/10.1159/000334154
Pun, Patrick H., and John P. Middleton. “Sudden cardiac death in hemodialysis patients: a comprehensive care approach to reduce risk.Blood Purif 33, no. 1–3 (2012): 183–89. https://doi.org/10.1159/000334154.
Pun, Patrick H., and John P. Middleton. “Sudden cardiac death in hemodialysis patients: a comprehensive care approach to reduce risk.Blood Purif, vol. 33, no. 1–3, 2012, pp. 183–89. Pubmed, doi:10.1159/000334154.
Journal cover image

Published In

Blood Purif

DOI

EISSN

1421-9735

Publication Date

2012

Volume

33

Issue

1-3

Start / End Page

183 / 189

Location

Switzerland

Related Subject Headings

  • Urology & Nephrology
  • Risk Factors
  • Renal Dialysis
  • Kidney Failure, Chronic
  • Humans
  • Defibrillators, Implantable
  • Death, Sudden, Cardiac
  • Comprehensive Health Care
  • 3202 Clinical sciences
  • 1103 Clinical Sciences