Cardiac death biggest risk for dialysis patients

BALTIMORE—Sudden cardiac death was found to be the number one cause of death for dialysis patients, according to a 10-year study of more than 1,000 kidney failure patients.

The study—which is already published online and will appear in the Nov. 2 issue of Kidney International—also identified systemic inflammatory response and malnutrition as key risk factors for the fatal heart attacks.

"This is believed to be the first time anyone has taken a rigorous prospective look at why so many patients on dialysis die from sudden cardiac death, and the results could help doctors identify those at highest risk and potentially save lives," said Rulan S. Parekh, MD, associate professor in the Department of Nephrology at the Johns Hopkins University School of Medicine.

Parekh and her team gathered their data from the Choices for Healthy Outcomes In Caring for ESRD (CHOICE) cohort of 1,041 end-stage renal disease (ESRD) patients on dialysis. In a 9.5-year period, 658 of this group died. The largest number of these deaths, 146, was the result of sudden cardiac death (SCD), in this case unexpected deaths that occurred outside of the hospital setting.

The researchers then looked at previously recorded blood test results from 122 of these 146 SCD patients to search for a possible relationship between the deaths and levels of high-sensitivity C-reactive (hsCRP), interlukin-6 (IL-6) and albumin. The proteins IL-6 and hsCRP are both markers for widespread blood vessel and organ inflammation, while low albumin levels are associated with malnutrition.