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Kidney Week

Abstract: TH-PO0525

Evaluating the Incidence of Sudden Cardiac Death (SCD) Among Patients on Dialysis over a Decade Within a Local Population in the United Kingdom (UK)

Session Information

Category: Dialysis

  • 801 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Lee, Han Sean, Northern Care Alliance NHS Foundation Trust, Salford, England, United Kingdom
  • Chinnadurai, Rajkumar, Northern Care Alliance NHS Foundation Trust, Salford, England, United Kingdom
  • Kalra, Philip A., Northern Care Alliance NHS Foundation Trust, Salford, England, United Kingdom
  • Poulikakos, Dimitrios J., Northern Care Alliance NHS Foundation Trust, Salford, England, United Kingdom
Background

SCD is reported to be the leading cause of death among dialysis patients. The latest United States Renal Data System report indicates that SCD accounts for 47% and 42% of deaths among patients with a known cause of death in the haemodialysis (HD) and peritoneal dialysis (PD) cohorts, respectively. Clinical trials with careful death adjudication consistently report that approximately 1 in 4 deaths are attributable to SCD. Despite this, many renal registries including the UK do not routinely collect data on SCD, resulting in the lack of global prevalence data for SCD.

Methods

This retrospective analysis included all patients who initiated HD and PD in the Northern Care Alliance, UK from 2014 to 2024 (n=1189; 83% HD, 17% PD). Deaths occurring up to the end of 2024 were identified for systemic adjudication by three independent clinicians based on the current widely accepted definition of SCD. Patients who were dialysed due to acute kidney injury, received a kidney transplant or moved out of area were excluded. Baseline characteristics were analysed through Mann-Whitney U and Chi-square tests. A multivariate logistic regression model was used to identify independent predictors of SCD.

Results

A total of 459 deaths (38.6% of patients) were reported and included in the systematic death adjudication. 103 (22.4%) deaths in dialysis patients were classified as SCD (23.4% HD, 17.9% PD). Compared to patients who died from other causes, those who experienced SCD were younger at the start of dialysis (median 65 vs. 71 years, p=0.015), less likely to be Caucasian (74.8% vs. 84.6%, p=0.022), more likely to have diabetes (49.5% vs. 39%, p=0.05), and had a higher prevalence of pre-existing cardiac disease (13.6% vs. 4.8%, p=0.002). Lower age of starting dialysis (Odds Ratio [OR] 0.97, 95% Confidence Interval [CI] 0.95 – 0.99, p=0.004) and a history of cardiac disease (OR 2.92, 95% CI 1.3 – 6.5, p=0.009) were found to be significant independent predictors of SCD.

Conclusion

The prevalence of SCD in the dialysis population in Salford, UK, aligns with current global SCD data, therefore validating the high burden of SCD. This finding could potentially bring value in reporting SCD nationally in the UK and underscore the need for focused cardiovascular risk assessment in this at-risk population.

Digital Object Identifier (DOI)