Sudden and cardiac death rates in hemodialysis patients
Sudden and cardiac death rates in hemodialysis patients
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DOI：
10.1046/j.1523-1755.1999.00391.x
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发表时间：
1999-04-01
影响因子：
19.6
通讯作者：
Satko, SG
中科院分区：
文献类型：
--
作者：
Bleyer, AJ;Russell, GB;Satko, SG
背景。猝死和心源性死亡（包括充血性心力衰竭、心肌梗塞和猝死）在血液透析患者中很常见。血液透析的间歇性可能导致一周内猝死和心源性死亡的分布不均匀。本研究的目的是评估血液透析患者猝死和心源性死亡的间隔心律。方法。我们获取了美国肾脏数据系统 (USRDS) 的数据，以检查 1977 年至 1997 年美国血液透析和腹膜透析患者的死亡日期。USRDS 的病例组合充分性研究中还确定了患者的死亡日期。结果。腹膜透析患者的猝死和心源性死亡分布均匀，血液透析患者死于非心源性死亡的分布也均匀。对于所有血液透析患者来说，周一和周二是猝死和心源性死亡最常见的日子。对于病例组合充分性研究中指定为周一、周三和周五透析患者的患者，20.8% 的猝死发生在周一，而预期为 14.3% (P = 0.002)。同样，20.2% 的心脏死亡发生在周一，而预期为 14.3% (P = 0.0005)。周二，周二、周四和周六的透析患者也发现了类似的趋势；结论。血液透析的间歇性可能导致周一和周二参加 USRDS 的患者猝死率和心源性死亡率增加。
Background. Sudden and cardiac death (including death from congestive heart failure, myocardial infarction, and sudden death) are common occurrences in hemodialysis patients. The intermittent nature of hemodialysis may lead to an uneven distribution of sudden and cardiac death throughout the week. The purpose of this study was to assess the septadian rhythm of sudden and cardiac death in hemodialysis patients.Methods. Data from the United States Renal Data System (USRDS) were obtained to examine the day of death for United States hemodialysis and peritoneal dialysis patients from 1977 through 1997. The days of death were also determined for patients in the Case Mix Adequacy Study of the USRDS.Results. There was an even distribution of sudden and cardiac deaths for patients on peritoneal dialysis, and hemodialysis patients dying of noncardiac deaths also had an even distribution. For all hemodialysis patients, Monday and Tuesday were the most common days of sudden and cardiac death. For patients in the Case Mix Adequacy Study designated as Monday, Wednesday, and Friday dialysis patients, 20.8% of sudden deaths occurred on Monday compared with the 14.3% expected (P = 0.002). Similarly, 20.2% of cardiac deaths occurred on Monday compared with the 14.3% expected (P = 0.0005). Similar trends were found on Tuesday for Tuesday, Thursday, and Saturday dialysis patients;Conclusions. The intermittent nature of hemodialysis may contribute to an increased sudden and cardiac death rate on Monday and Tuesday for patients enrolled in the USRDS.