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Nefrología (Madrid)

On-line version ISSN 1989-2284Print version ISSN 0211-6995


CARAVACA, Francisco et al. Sudden cardiac death in non-dialysis chronic kidney disease patients. Nefrología (Madr.) [online]. 2016, vol.36, n.4, pp.404-409. ISSN 1989-2284.


A relatively high proportion of deaths in dialysis patients occur suddenly and unexpectedly. The incidence of sudden cardiac death (SCD) in non-dialysis advanced chronic kidney disease (CKD) stages has been less well investigated.


This study aims to determine the incidence and predictors of SCD in a cohort of 1078 patients with CKD not yet on dialysis.


Prospective observational cohort study, which included patients with advanced CKD not yet on dialysis (stage 4-5). The association between baseline variables and SCD was assessed using Cox and competing-risk (Fine and Grey) regression models. Demographic, clinical information, medication use, and baseline biochemical parameters of potential interest were included as covariates.


During the study period (median follow-up time 12 months), 210 patients died (19%), and SCD occurred in 34 cases (16% of total deaths). All-cause mortality and SCD incidence rates were 113 (95% CI: 99-128), and 18 (95% CI: 13-26) events per 1000 patients/year, respectively. By Cox regression analysis, covariates significantly associated with SCD were: Age, comorbidity index, and treatment with antiplatelet drugs. This latter covariate showed a beneficial effect over the development of SCD. By competing-risk regression, in which the competing event was non-sudden death from any cause, only age and comorbidity index remained significantly associated with SCD.


SCD is relatively common in non-dialysis advanced CKD patients. SCD was closely related to age and comorbidity, and some indirect data from this study suggest that unrecognised or undertreated cardiovascular disease may predispose to a higher risk of SCD.

Keywords : Chronic kidney disease; Pre-dialysis; Sudden cardiac death; Mortality; Cardiovascular risk.

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