Journal Article

Unexplained sudden death in patients on the waiting list for renal transplantation

Jose Jayme Galvão De Lima, Luis Henrique Wolff Gowdak, Flavio Jota de Paula, Rodolfo Leite Arantes, Luiz Antonio Machado César, Jose Antonio Franchini Ramires and Eduardo M. Krieger

in Nephrology Dialysis Transplantation

Published on behalf of European Renal Association - European Dialysis and Transplant Assoc

Volume 26, issue 4, pages 1392-1396
Published in print April 2011 | ISSN: 0931-0509
Published online September 2010 | e-ISSN: 1460-2385 | DOI: http://dx.doi.org/10.1093/ndt/gfq570
Unexplained sudden death in patients on the waiting list for renal transplantation

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Background. The incidence of unexplained sudden death (SD) and the factors involved in its occurrence in patients with chronic kidney disease are not well known.

Methods. We investigated the incidence and the role of co-morbidities in unexplained SD in 1139 haemodialysis patients on the renal transplant waiting list.

Results. Forty-four patients died from SD of undetermined causes (20% of all deaths; 3.9 deaths/1000 patients per year), while 178 died from other causes and 917 survived. SD patients were older and likely to have diabetes, hypertension, past/present cardiovascular disease, higher left ventricular mass index, and lower ejection fraction. Multivariate analysis showed that cardiovascular disease of any type was the only independent predictor of SD (P = 0.0001, HR = 2.13, 95% CI 1.46–3.22). Alterations closely associated with ischaemic heart disease like angina, previous myocardial infarction and altered myocardial scan were not independent predictors of SD. The incidence of unexplained SD in these haemodialysis patients is high and probably a consequence of pre-existing cardiovascular disease.

Conclusions. Factors influencing SD in dialysis patients are not substantially different from factors in the general population. The role played by ischaemic heart disease in this context needs further evaluation.

Keywords: cardiovascular disease; chronic kidney disease; dialysis; sudden death; transplantation

Journal Article.  3046 words. 

Subjects: Nephrology

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