| Abstract: |
This article presents the nephrologist’s perspective on the prevention of sudden cardiac death in dialysis patients, an unfortunately common event in the dialysis population. The author stresses that prevention of sudden death can be accomplished in this group by proper management of cardiac disease and attention to dialysis treatment. The proper usage of medications such as ACE inhibitors and beta blockers is likely to decrease the risk of sudden death, yet these medications are underused in the dialysis population. The author discusses dialysis treatment as a cardiac stress, the appropriate management of dialysate potassium, and volume shifts occurring during dialysis. The author calls for the development in each dialysis center of a systematic method to identify risk factors for sudden death, institute appropriate treatment, and monitor outcomes. Most of the systems currently in place concentrate on the dialysis procedure, with most time in dialysis rounds covering dialysis adequacy, calcium phosphate metabolism, anemia, and adjustment of dry weight. The evaluation of cardiac risk factors must be incorporated into this system of patient care. 29 references. |