Sudden Cardiac Death: A Major Cause of Death in Dialysis Patients
Cardiac disease is the major cause of death among dialysis patients. In the United States Renal Data System (USRDS) database, the single, largest, specific cause of death is attributed to arrhythmic mechanisms or sudden cardiac death (SCD). The overall best estimate is that SCD is responsible for approximately 29 percent of all-cause mortality in dialysis patients.
In the general as well as the dialysis population, most SCA events are believed to be due to ventricular arrhythmias; that is, ventricular tachycardia (VT) or ventricular fibrillation (VF). A minority may have been attributed to bradyarrhythmia’s.
The increased risk associated with low-potassium dialysate was greatest at lower levels of pre dialysis serum potassium. Increased ultrafiltration volume and low-calcium dialysate were also linked to SCA in this study. Compared with dialysate potassium ≥3 mEq/L, dialysate potassium concentrations ≤1.5 and ≤2 to 2.5 mEq/L were associated with increased risk of SCD.
Evercare Hospital’s Low Mortality Rate for Dialysis Patients
In Evercare Hospital for the first time in Bangladesh we have modified our dialysis potassium and calcium bath to reduced mortality, intradialytic hypertension, and cardiac events. We are offering high potassium low calcium bath dialysate specially for patients who are having intradialytic hypertension and cardiac arrhythmia.
Our dialysis mortality rate (21%) is lower than the international standard mortality rate in developed countries. We are continuously improving our standards and currently doing CRRT with online dialysate fluid which is a cheaper and more effective option for critical patients then with prepared dialysate bags.
Dr. Ebadur Rahman
MRCP(UK), FRCP(UK), FRCPI, FASN, MMEDSCI (UK) DM(UK), Sren nephrology (UK).
Senior Consultant
Department of Nephrology
Evercare Hospital Dhaka
Vice President of IRTA
E-MAIL: ebadurmr@gmail.com, ebadur.rahman@evercarebd.com