Nephrology Dialysis Transplantation, Vol 12, Issue 5 952-955, Copyright © 1997 by Oxford University Press
K Takeda, A Harada, S Okuda, S Fujimi, Y Oh, F Hattori, K Motomura, H Hirakata and M Fujishima
Methods. Causes of sudden death were investigated in
113 chronic dialysis patients who died during the 10-year period from July
1979 to January 1989; post-mortem examination was performed on 93 of the
cases (autopsy rate; 82.3%). Sudden death was regarded as death 24 h after
the onset of acute illness in patients without any restriction in their
daily activities. There were 35 sudden death cases out of the 93 autopsied
chronic dialysis patients. We analysed the causes of sudden death for all
chronic dialysis patients and for those who died suddenly.
Results. The mean age of the 93 cases was 61.4
± 10.5 years (±SD). Stroke was the most frequent
cause of death (24 cases, 25.8%) in the 93 autopsied cases. This was
followed by cardiac disease in 18 (19.4%), infectious disease in 16
(17.2%), malignancy in 14 (15.1%), and dissecting aortic aneurysm in 5
(5.4%). The mean age of the 35 sudden death cases was 60.9 ±
10.9 years. Of the 35 sudden death cases in chronic dialysis patients,
dissecting aortic aneurysm was the most common cause of sudden death (5
cases, 14.3%), followed by cerebral haemorrhage in three (8.6%), acute
subdural haematoma in three (8.6%), acute myocardial infarction in two
(5.7%), cerebral infarction in two (5.7%), and subarachnoidal haemorrhage
in one (2.9%). Conclusions. Dissecting aortic
aneurysm, leading frequently to stroke as a cause of sudden death in
chronic dialysis patients, at least in Japan, should be carefully
differentiated from other cardiac disease in chronic dialysis patients,
such as severe atherosclerosis. Keywords: chronic
dialysis patients; sudden death; stroke; dissecting aortic aneurysm; severe
atherosclerosis
ORIGINAL ARTICLES
Sudden death in chronic dialysis patients
Second Department of Internal Medicine, Faculty of Medicine, Kyushu University, Fukuoka, Japan; Kidney Center, Matsuyama Red Cross Hospital, Matsuyama, Japan; Kidney Center, Fukuoka Red Cross Hospital, Fukuoka, Japan; Correspondence to K Takeda, Kidney Center, Saiseikai Yahata Hospital, Harunomachi 5-9-27, Yahatahigashi-ku, Kitakyushu 805, Japan
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