The worsening of left ventricular hypertrophy is the strongest predictor of sudden cardiac death in haemodialysis patients: A 10 year survey

Ernesto Paoletti, Claudia Specchia, Giovanni Di Maio, Diego Bellino, Beatrice Damasio, Paolo Cassottana, Giuseppe Cannella

Research output: Contribution to journalArticle

Abstract

Background. Although the incidence of sudden cardiac death (SCD) is high among haemodialysis (HD) patients, there are few papers available on this topic. The aim of this study on a single-centre HD population observed over a 10 year period was to identify patient- and HD-related specific factors that might be associated with a higher risk of SCD. Methods. The study included 123 patients (76 men; age 29-79 years) undergoing renal replacement therapy at our dialysis unit for at least 6 months. For each patient, routine laboratory tests were performed monthly, blood pressure was measured both at the start and the end of each dialysis session, haemoglobin and pre-dialysis serum K+ were determined weekly, serum iPTH was assessed thrice yearly, and an echocardiographic study was performed annually to determine the left ventricular mass index (LVMi). The prevalence of cardiovascular (CV) co-morbidities, and the incidence of new events were also recorded. Results. During the 10 years, 85 patients died - 16 from SCD, 30 from cardiac causes (CC) other than SCD, and 39 from other causes (OC); 38 patients were still alive (AL) at the end of the observation period. Comparative analysis of SCD, CC, OC and AL, reveals that the male prevalence (13/3) was higher in SCD than in AL, while AL were younger than the deceased patients regardless of the cause of death (P2 body surface area] compared with OC (-5±35), AL (-17±25) and even CC (7±30) (P<0.0001; ANOVA); finally, the prevalence of patients with ischaemic heart disease (IHD) was higher in the SCD group (11/5; P2). Univariate Cox regression analysis demonstrated that the factors increasing the risk of SCD were IHD (P=0.002), the worsening of left ventricular hypertrophy (LVH) (P

Original languageEnglish
Pages (from-to)1829-1834
Number of pages6
JournalNephrology Dialysis Transplantation
Volume19
Issue number7
DOIs
Publication statusPublished - Jun 2004

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antineoplaston A10
Sudden Cardiac Death
Left Ventricular Hypertrophy
Renal Dialysis
Dialysis
Myocardial Ischemia
Renal Replacement Therapy
Surveys and Questionnaires
Body Surface Area
Incidence
Serum
Cause of Death
Analysis of Variance
Hemoglobins
Regression Analysis
Observation
Blood Pressure
Morbidity
Population

Keywords

  • Haemodialysis
  • Left ventricular hypertrophy
  • Sudden cardiac death

ASJC Scopus subject areas

  • Nephrology
  • Transplantation

Cite this

The worsening of left ventricular hypertrophy is the strongest predictor of sudden cardiac death in haemodialysis patients : A 10 year survey. / Paoletti, Ernesto; Specchia, Claudia; Di Maio, Giovanni; Bellino, Diego; Damasio, Beatrice; Cassottana, Paolo; Cannella, Giuseppe.

In: Nephrology Dialysis Transplantation, Vol. 19, No. 7, 06.2004, p. 1829-1834.

Research output: Contribution to journalArticle

Paoletti, Ernesto ; Specchia, Claudia ; Di Maio, Giovanni ; Bellino, Diego ; Damasio, Beatrice ; Cassottana, Paolo ; Cannella, Giuseppe. / The worsening of left ventricular hypertrophy is the strongest predictor of sudden cardiac death in haemodialysis patients : A 10 year survey. In: Nephrology Dialysis Transplantation. 2004 ; Vol. 19, No. 7. pp. 1829-1834.
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T1 - The worsening of left ventricular hypertrophy is the strongest predictor of sudden cardiac death in haemodialysis patients

T2 - A 10 year survey

AU - Paoletti, Ernesto

AU - Specchia, Claudia

AU - Di Maio, Giovanni

AU - Bellino, Diego

AU - Damasio, Beatrice

AU - Cassottana, Paolo

AU - Cannella, Giuseppe

PY - 2004/6

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AB - Background. Although the incidence of sudden cardiac death (SCD) is high among haemodialysis (HD) patients, there are few papers available on this topic. The aim of this study on a single-centre HD population observed over a 10 year period was to identify patient- and HD-related specific factors that might be associated with a higher risk of SCD. Methods. The study included 123 patients (76 men; age 29-79 years) undergoing renal replacement therapy at our dialysis unit for at least 6 months. For each patient, routine laboratory tests were performed monthly, blood pressure was measured both at the start and the end of each dialysis session, haemoglobin and pre-dialysis serum K+ were determined weekly, serum iPTH was assessed thrice yearly, and an echocardiographic study was performed annually to determine the left ventricular mass index (LVMi). The prevalence of cardiovascular (CV) co-morbidities, and the incidence of new events were also recorded. Results. During the 10 years, 85 patients died - 16 from SCD, 30 from cardiac causes (CC) other than SCD, and 39 from other causes (OC); 38 patients were still alive (AL) at the end of the observation period. Comparative analysis of SCD, CC, OC and AL, reveals that the male prevalence (13/3) was higher in SCD than in AL, while AL were younger than the deceased patients regardless of the cause of death (P2 body surface area] compared with OC (-5±35), AL (-17±25) and even CC (7±30) (P<0.0001; ANOVA); finally, the prevalence of patients with ischaemic heart disease (IHD) was higher in the SCD group (11/5; P2). Univariate Cox regression analysis demonstrated that the factors increasing the risk of SCD were IHD (P=0.002), the worsening of left ventricular hypertrophy (LVH) (P

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