Early detection and prevention of cardiac event in chronic hemodialysis patients

Abstract

Hemodialysis patients have a worse prognosis than non-dialysis patients. In addition to sudden cardiac death, they are at an increased risk to many acute onset conditions. This retrospective study evaluated hemodialysis patients who received cardiopulmonary resuscitation at our hospital between April 1, 2011 and May 31, 2016. The percentage of patients at our hospital who require hemodialysis increased annually, and the risk of sudden death was more than a hundredfold greater than in patients who did not require hemodialysis. Of the 117 cases of sudden death at our hospital, 17 were hemodialysis patients and all the patients who received cardiopulmonary resuscitation were hemodialysis patients. Emergency hospital admission of hemodialysis patients was more frequent for acute onset conditions than admission for other reasons. The possibility of rehabilitation of hemodialysis patients requiring cardiopulmonary resuscitation is very low. Hemodialysis patients had a variety of admission diagnoses ; the most common were acute cardiovascular complications against a background of previous heart disease. For these reasons, cardiovascular monitoring, including electrocardiography and management of electrolytes, during and after hemodialysis is important for early detection and prevention of acute onset events.