#3173 INCIDENCE AND RISK FACTORS OF SUDDEN CARDIAC DEATH IN END STAGE RENAL DISEASE PATIENTS UNDERGOING HAEMODIALYSIS: A RETROSPECTIVE STUDY

Abstract

Abstract Background & aims: End Stage Renal Disease (ESRD) patients undergoing haemodialysis are prone to suffer from Sudden Cardiac Death (SCD). The present study was sought to evaluate the incidence and risk factors of SCD in ESRD patients on haemodialysis in Pakistani population. Methods The study recruited 202 eligible ESRD patients undergoing haemodialysis. Baseline characteristics of the study participants with and without Sudden Cardiac Arrest (SCA) were recorded using self-reported questionnaires. SCA and SCD events were identified by reviewing medical records and death certificates. Results Out of 202 patients, 37 (18.3%) suffered from the episode of SCA, 18 (48.6%) of which succumbed to death. ESRD patients who endured SCA were statistically older in comparison with their non-SCA counterparts (58.2 ± 11.4 vs. 52.3 ± 9.3 years, P<0.001). The HTN (67.6% versus 64.8%, P = 0.001), DM (62.2% versus 59.4%, P = 0.004), CAD (45.9% versus 41.8%, P = 0.001) and Congestive Heart Failure (CHF) (35.1% versus 34.5%, P = 0.002) were significantly prevalent in ESRD cohort with SCA in contrast to non-SCA. We also found LVH (62.2% versus 48.5%, P<0.001), ventricular tachycardia (51.4% versus 30.9%, P<0.001) and ventricular fibrillation/flutter (56.8% versus 25.5%, P<0.001) to be statistically higher in ESRD patients on haemodialysis with SCA event. Through multivariate logistic regression analysis, we evidenced hypokalemia (OR = 1.247, CI 1.214 – 1.278, P<0.001); CAD (OR 1.886, CI 1.469 – 2.342, P<0.001); LVH (OR 1.861, CI 1.392 – 1.953, P<0.001); ventricular tachycardia (OR = 1.253, CI 1.012 – 1.386, P<0.001); and ventricular fibrillation/flutter (OR = 0.547, CI 0.518 – 0.773, P<0.001) to be significantly and independently associated with SCD in ESRD patients on haemodialysis. Conclusion The prevalence of SCD among ESRD patients on haemodialysis with SCA episode is very high. CAD and ventricular tachyarrhythmias were statistically significant among ESRD patients on haemodialysis with SCA in comparison with non-SCA and were independently associated with the prevalence of in-patient SCD among ESRD patients with SCA on haemodialysis.