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Chronic kidney disease is associated with increased risk of sudden cardiac death among patients with coronary artery disease.

Publication ,  Journal Article
Pun, PH; Smarz, TR; Honeycutt, EF; Shaw, LK; Al-Khatib, SM; Middleton, JP
Published in: Kidney Int
September 2009

Sudden cardiac death is the most common cause of mortality among patients with end-stage kidney disease maintained on hemodialysis. To examine whether this increased risk is also seen with less advanced kidney disease, we studied the relationship between glomerular filtration rate and risk of sudden cardiac death in patients with moderate kidney disease and known coronary artery disease. This retrospective longitudinal study encompassed 19,440 consecutive patients who underwent cardiac catheterization at a single academic institution. There were 522 adjudicated sudden cardiac death events, yielding an overall rate of 4.6 events per 1000 patient years. This figure reflected rates of 3.8 events in 14,652 patients with estimated glomerular filtration rates (eGFR) > or =60 (stage 2 CKD or better) and 7.9 events in 4788 patients with glomerular filtration rates <60 (stage 3-5 CKD), all normalized to 1000 patient-years. After adjusting for differences in known cardiac risk factors and other covariates in a multivariate Cox proportional hazards model, the eGFR was independently associated with sudden cardiac death (hazard ratio (HR)=1.11 per 10 ml/min decline in the eGFR). Our analysis found that reductions in the eGFR in CKD stages 3-5 are associated with a progressive increase in risk of sudden cardiac death in patients with coronary artery disease. Additional studies are needed to better characterize the mechanisms by which reduced kidney function increases this risk.

Duke Scholars

Published In

Kidney Int

DOI

EISSN

1523-1755

Publication Date

September 2009

Volume

76

Issue

6

Start / End Page

652 / 658

Location

United States

Related Subject Headings

  • Urology & Nephrology
  • Risk
  • Retrospective Studies
  • Proportional Hazards Models
  • Middle Aged
  • Male
  • Longitudinal Studies
  • Kidney Diseases
  • Humans
  • Glomerular Filtration Rate
 

Citation

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Pun, P. H., Smarz, T. R., Honeycutt, E. F., Shaw, L. K., Al-Khatib, S. M., & Middleton, J. P. (2009). Chronic kidney disease is associated with increased risk of sudden cardiac death among patients with coronary artery disease. Kidney Int, 76(6), 652–658. https://doi.org/10.1038/ki.2009.219
Pun, Patrick H., Thomas R. Smarz, Emily F. Honeycutt, Linda K. Shaw, Sana M. Al-Khatib, and John P. Middleton. “Chronic kidney disease is associated with increased risk of sudden cardiac death among patients with coronary artery disease.Kidney Int 76, no. 6 (September 2009): 652–58. https://doi.org/10.1038/ki.2009.219.
Pun PH, Smarz TR, Honeycutt EF, Shaw LK, Al-Khatib SM, Middleton JP. Chronic kidney disease is associated with increased risk of sudden cardiac death among patients with coronary artery disease. Kidney Int. 2009 Sep;76(6):652–8.
Pun, Patrick H., et al. “Chronic kidney disease is associated with increased risk of sudden cardiac death among patients with coronary artery disease.Kidney Int, vol. 76, no. 6, Sept. 2009, pp. 652–58. Pubmed, doi:10.1038/ki.2009.219.
Pun PH, Smarz TR, Honeycutt EF, Shaw LK, Al-Khatib SM, Middleton JP. Chronic kidney disease is associated with increased risk of sudden cardiac death among patients with coronary artery disease. Kidney Int. 2009 Sep;76(6):652–658.
Journal cover image

Published In

Kidney Int

DOI

EISSN

1523-1755

Publication Date

September 2009

Volume

76

Issue

6

Start / End Page

652 / 658

Location

United States

Related Subject Headings

  • Urology & Nephrology
  • Risk
  • Retrospective Studies
  • Proportional Hazards Models
  • Middle Aged
  • Male
  • Longitudinal Studies
  • Kidney Diseases
  • Humans
  • Glomerular Filtration Rate