19). Among patients receiving cinacalcet, the average carotid-femoral pulse wave velocity increased from 10.46 ± 2.12 m/s at baseline to 11.41 ± 2.79 m/s at 52 weeks (P = 0.001). The change in carotid-femoral pulse wave velocity over 1 year had no significant correlation with the final parathyroid hormone level or change in parathyroid hormone level. Among prevalent patients receiving peritoneal dialysis and with hyperparathyroidism, a reduction of 60.6% parathyroid hormone level after cinacalcet treatment for one year did not reduce the carotid-femoral pulse wave velocity. “
“Sudden cardiac MK-2206 mw death (SCD) is the most common cause of death
in haemodialysis patients, accounting for 25% of all-cause mortality. There are many potential pathological precipitants as most patients with end-stage renal disease have structurally or functionally abnormal hearts. For example, at initiation of dialysis, 74% of patients have left ventricular hypertrophy. The pathophysiological and metabolic milieu of patients with end-stage renal disease, allied to the regular stresses of dialysis, may provide
the trigger to a fatal cardiac event. Prevention of SCD can be seen as a legitimate target to improve survival in this patient group. In the general population, this is most effective by reducing the burden of ischaemic heart disease. However, selleck screening library the aetiology of SCD in haemodialysis patients appears to be different, with myocardial fibrosis, vascular calcification and autonomic
dysfunction implicated as possible causes. Thus, the range of therapies is different to the general population. There are potential preventative measures emerging as our understanding of the underlying mechanisms progresses. This article aims to review the evidence for therapies to prevent SCD effective in the general population when applied to dialysis Liothyronine Sodium patients, as well as promising new treatments specific to this population group. The most widely agreed definition of sudden cardiac death (SCD) is unexpected cardiac death that occurs within 1 h of onset of symptoms in a person without a prior condition that would appear fatal.[1] In end stage kidney disease (CKD-5D) patients undergoing haemodialysis, SCD is common. The United States Renal Data System (USRDS) reports that ‘cardiac death, cause unknown’ and arrhythmia account for 25% of all-cause mortality at a rate of 90–200 events/1000 patient-years.[2] This compares with 1–2 events/1000 patient-years in the general population. However, epidemiological data pertaining to the fatal rhythm in dialysis patients who suffer SCD are lacking. Cardiac structure and function are frequently abnormal in CKD-5D; findings associated with vulnerability to malignant arrhythmia. It is likely that SCD is a result of various triggers on an already abnormal myocardium (Fig. 1). For example, dialysis itself is likely to play a prominent role.