scholarly journals Chronic Kidney Disease and Mortality in Implantable Cardioverter-Defibrillator Recipients

2010 ◽  
Vol 2010 ◽  
pp. 1-6 ◽  
Author(s):  
Aamir Cheema ◽  
Tejwant Singh ◽  
Manreet Kanwar ◽  
Karuna Chilukuri ◽  
Viqar Maria ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Sudden Cardiac Death ◽  
Kidney Disease ◽  
Mortality Rate ◽  
Cardiac Death ◽  
Implantable Cardioverter Defibrillators ◽  
Icd Implantation ◽  
Arrhythmic Death ◽  
Stage Renal Disease ◽  
The Impact

Incidence of sudden cardiac death (SCD) in end-stage renal disease (ESRD) remains high. Limited data is available about whether implantable cardioverter-defibrillators (ICDs) can prevent arrhythmic death in patients with chronic kidney disease (CKD). The purpose of this retrospective study was to determine the impact of CKD on all-cause and sudden cardiac death in ICD recipients. We evaluated 441 consecutive patients who underwent ICD implantation at our center between 1994 and 2002. We found that mortality rate was higher in patients with eGFR<60 mL/min and those with ESRD on hemodialysis (43%,n=69/162and 54%,n=12/22, resp.) than in patients with eGFR≥60 mL/min (23%,n=58/257;P<.0005). The SCD rate was also higher in the patients with ESRD (50%) than in CKD patients not on dialysis (10.2%;P<.0005). Mortality rate for single-chamber ICDs was 56.8% in comparison with dual-chamber ICDs (38.1%) and for biventricular ICDs (5.0%) (P<.0005).

Sudden cardiac death in chronic kidney disease

2015 ◽  
Author(s):  
Reza Hajhosseiny ◽  
Kaivan Khavandi ◽  
David J. Goldsmith
Keyword(s):  
Chronic Kidney Disease ◽  
Sudden Cardiac Death ◽  
Kidney Disease ◽  
Cardiac Death ◽  
Beta Blockers ◽  
Good Reason ◽  
Epidemiological Data ◽  
Icd Implantation ◽  
Stage Renal Disease ◽  
End Stage

Epidemiological data demonstrate the unique vulnerability of chronic kidney disease (CKD) subjects to cardiovascular disease, the most catastrophic being sudden cardiac death (SCD). In patients with declining kidney function there is a continuum of cardiovascular risk. In those individuals who survive to reach end-stage renal disease (ESRD), the risk of suffering a cardiac event is extremely high. Some of this risk is explained by the common risk factors and traditional cardiovascular events, namely atherosclerotic plaque fissure and rupture, but there is now evidence of a distinct ‘later CKD’ mechanism, notably arrhythmias. This appears particularly true in later stages of CKD and corresponds with the multifaceted range of myocardial and vascular insults operating. The physiological milieu of disordered vessel autoregulation, sequestered vasoprotective agents, loss of conduit and small artery elasticity/compliance, a stiffened and fibrotic myocardium, with calcified and diseased coronary arteries, all within an inflammatory environment, all contribute to arrhythmia generation. The final insult is changes in volume and electrolyte status. Risk stratification tools would be helpful in guiding clinicians to recognize those subjects likely to benefit from specific interventional strategies. These might include the novel, or emerging serum, haemodynamic, or electrocardiographic biomarkers in CKD. Current tools—such as those used for stratifying risk for SCD and determining the need for ICD implantation—are not valid in ESRD patients. Beta blockers appear likely to be generally advisable, blood pressure permitting, for patients with significant cardiomyopathy. Evidence for implantable cardiac defibrillators (ICD) is lacking. There is good reason to think that young dialysis patients at high risk of sudden death may benefit, but the risk/benefit ratio for older patients is less likely to be advantageous. These hypotheses need further investigation.

scholarly journals Egg Intake in Chronic Kidney Disease

Nutrients ◽  
2018 ◽  
Vol 10 (12) ◽  
pp. 1945 ◽  
Author(s):  
Dina Tallman ◽  
Sharmela Sahathevan ◽  
Tilakavati Karupaiah ◽  
Pramod Khosla
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Muscle Protein ◽  
Muscle Protein Synthesis ◽  
Dietary Cholesterol ◽  
Egg Yolk ◽  
Epidemiological Studies ◽  
Egg Consumption ◽  
Stage Renal Disease ◽  
The Impact

Patients with chronic kidney disease (CKD) are often instructed to adhere to a renal-specific diet depending on the severity and stage of their kidney disease. The prescribed diet may limit certain nutrients, such as phosphorus and potassium, or encourage the consumption of others, such as high biological value (HBV) proteins. Eggs are an inexpensive, easily available and high-quality source of protein, as well as a rich source of leucine, an essential amino acid that plays a role in muscle protein synthesis. However, egg yolk is a concentrated source of both phosphorus and the trimethylamine N-oxide precursor, choline, both of which may have potentially harmful effects in CKD. The yolk is also an abundant source of cholesterol which has been extensively studied for its effects on lipoprotein cholesterol and the risk of cardiovascular disease. Efforts to reduce dietary cholesterol to manage dyslipidemia in dialysis patients (already following a renal diet) have not been shown to offer additional benefit. There is a paucity of data regarding the impact of egg consumption on lipid profiles of CKD patients. Additionally, egg consumption has not been associated with the risk of developing CKD based on epidemiological studies. The egg yolk also contains bioactive compounds, including lutein, zeaxanthin, and vitamin D, which may confer health benefits in CKD patients. Here we review research on egg intake and CKD, discuss both potential contraindications and favorable effects of egg consumption, and describe the need for further research examining egg intake and outcomes in the CKD and end-stage renal disease population.

scholarly journals The Enormity of Chronic Kidney Disease in Nigeria: The Situation in a Teaching Hospital in South-East Nigeria

2010 ◽  
Vol 2010 ◽  
pp. 1-6 ◽  
Author(s):  
Ifeoma I. Ulasi ◽  
Chinwuba K. Ijoma
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Renal Disease ◽  
Teaching Hospital ◽  
Dialysis Unit ◽  
Female Patients ◽  
Prohibitive Cost ◽  
Stage Renal Disease ◽  
The Impact ◽  
Esrd Patients

Background. The magnitude of the problem of chronic kidney disease (CKD) is enormous, and the prevalence keeps rising. To highlight the burden of CKD in developing countries, the authors looked at end-stage renal disease (ESRD) patients seen at the University of Nigeria Teaching Hospital (UNTH), Enugu, South-East Nigeria.Method. ESRD patients seen from 01/05/1990 to 31/12/2003 were recruited. Records from A&E Department, medical-out-patients, wards and dialysis unit were used.Results. A total of 1001 male versus 537 female patients were reviewed. About 593 male versus 315 female patients had haemodialysis. The mean age was years and 86.5% were <60 years. Primary renal disease could not be determined in 51.6% while hypertension and glomerulonephritis accounted for −17.2% and 14.6%, respectively. Death from renal causes constituted 22.03% of medical deaths.Conclusion. The prognosis for CKD patients in Nigeria is abysmal. Only few patients had renal-replacement-therapy (RRT). The prohibitive cost precludes many patients. This underscores the need for preventive measures to reduce the impact of CKD in the society.

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