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Kidney Patients More Susceptible to Sudden Cardiac Death

FRIDAY Oct. 31, 2008 -- Sudden cardiac death is the leading cause of death among kidney failure patients, and inflammation and malnutrition are major risk factors for fatal heart attacks in these people, Johns Hopkins researchers report.

The researchers analyzed data from 1,041 end-stage renal disease (ESRD) patients on dialysis. Over 9.5 years, there were 658 deaths, including 146 cases of sudden cardiac death.

The Hopkins team then looked at previously recorded blood test results from 122 of those 146 patients to check levels of high-sensitivity C-reactive protein (hsCRP), interleukin-6 (IL-6) and albumin. Low albumin levels are associated with malnutrition, while the proteins hsCRP and IL-6 are markers of widespread blood vessel and organ inflammation.

Patients with high levels of either hsCRP or IL-6 were twice as likely to experience sudden cardiac death as patients with low levels of the enzymes, the study found. Patients with low albumin levels were 1.35 times more likely to die that way than those with high albumin levels. Patients with both high levels of hsCRP and low levels of albumin were four times more likely to have sudden cardiac death than those with low levels of hsCRP and high albumin levels.

The study was published online and was expected to be in the Nov. 2 print issue of Kidney International.

"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," study author Dr. Rulan S. Parekh, an associate professor in the department of nephrology at the Johns Hopkins University School of Medicine, said in a Hopkins news release.

She noted that the 500,000 people in the United States with ESRD are 10 times to 100 times more likely to die from cardiovascular disease than the general public.

"When people think of heart attacks, they think of cholesterol and obesity, but these are risk factors for hardening of the arteries and are not directly linked to sudden heart death among patients on dialysis," Parekh said.

More information

The U.S. National Institute of Diabetes and Digestive and Kidney Diseases has more about kidney disease and failure.

Posted: October 2008


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