Abstract: FR-PO798
Characteristics of Sudden Cardiac Death in Our Hemodialysis Unit
Session Information
- Dialysis: Hospitalization and Mortality
October 26, 2018 | Location: Exhibit Hall, San Diego Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 701 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Mon, Carmen, Hospital Severo Ochoa, Madrid, Spain
- Ortiz, Milagros, Hospital Severo Ochoa, Madrid, Spain
- Ortega, Olimpia, Hospital Severo Ochoa, Madrid, Spain
- Oliet, Aniana, Hospital Severo Ochoa, Madrid, Spain
- Sanchez, Maria, Hospital Severo Ochoa, Madrid, Spain
- Camacho, Rosa Elena, Hospital Severo Ochoa, Madrid, Spain
- Arroyo, David, Hospital Severo Ochoa, Madrid, Spain
- Urdaneta, Jessica, Hospital Severo Ochoa, Madrid, Spain
- Navazo, Diego, Hospital Severo Ochoa, Madrid, Spain
- Herrero, Juan Carlos, Hospital Severo Ochoa, Madrid, Spain
Background
In hemodialysis (HD) patients sudden cardiac death (SCD) accounts for one out of every four deaths.It is complicated to determine how unexpected death is on ESRD patients whose illness is chronic and have a high comorbidity.Our aim was to study mortality in our dialysis unit, focusing on SCD.
Methods
Retrospectively, we collected mortality data for ten years. Clinical, biochemical (analytical closer to the date of death) and causes of death were analyzed. SCD was defined as an unexpected circulatory arrest or an unwitnessed, unexpected death in patients known to be well within the past 24 h.
Results
215 deaths were reviewed. First cause of death was cardiovascular disease (CVD) (54 p, 25%), the second SCD (42p, 19%). Risk factors for SCD at univariate study are showed in Table 1.In the logistic regression analysis, SCD was associated with: lack of AF (p0,05, HR0,27,CI 0,107-0,67) , higher potassium levels (p0,02, HR1,64,CI 1.0,7- 2,4), higher albumin levels (p0,02,HR2,CI 1,1-3,8) and lower CRP levels (p:0,01 HR0,99,CI 0,98-0,99).
Conclusion
SCD was the second cause of death in our HD patients and was not associated to traditional risk factors.There was no relationship between SCD and previous diagnosis of CVD, malnutrition and inflammation nor structural heart disease (AF). High value of serum potassium was the only risk factor associated to SCD that we can modify.
| SCD | NO SCD | p | |
| N | 175 | 42(19,5%) | |
| Age, y | 68,5±10,5 | 70,3±11,8 | NS |
| Males | 55,8% | 57,2% | NS |
| Diabetic Neph. | 37% | 18,9% | 0,03 |
| Death at home | 72,5% | 4,5% | 0,00 |
| ICCh | 4,8±1,9 | 5,2±2,1 | NS |
| Vintage (m) | 52,8±42 | 59,3±65 | NS |
| Atrial fibrillation (AF) | 19,1% | 37,6% | 0,02 |
| Cholesterol | 124,5±31 | 112,9 41 | 0,05 |
| Albumin | 3,1±0,7 | 2,6±0,64 | 0,00 |
| Hemoglobin | 11±2,1 | 10,1±1,7 | 0,03 |
| CRP | 47±59 | 112±102 | 0,00 |
| Ferritin | 332±263 | 684,7±833,7 | 0,00 |
| Transferrin | 164,3±49,8 | 130,7±41 | 0,00 |
| Sodium | 136,6± 3,8 | 136±4,6 | NS |
| Potassium | 4,8± 0,9 | 4,3±1 | 0,00 |
| Bicarbonate | 25,6±3,6 | 25±4,4 | NS |
| Phosphate | 4,1± 1,8 | 4,5±1,7 | NS |