Heritability of Risk for Sudden Cardiac Arrest in ESRD

J Am Soc Nephrol. 2015 Nov;26(11):2815-20. doi: 10.1681/ASN.2014090881. Epub 2015 Apr 16.

Abstract

Patients on dialysis are 20 times more likely to have a cardiac arrest compared with the general population. We considered whether inherited factors associate with cardiac arrest among patients on dialysis. From a sample of 647,457 patients on chronic dialysis, we identified 5117 pairs of patients who came from the same family. These patients were each matched to a control subject from the same population. McNemar's tests were used to compare the risk of cardiac arrest between the familial related and unrelated pairs. Genetically related family members who did not cohabitate had an odds ratio of 1.88 (95% confidence interval [95% CI], 1.25 to 2.84) for cardiac arrest compared with their phenotypically matched unrelated controls. Genetically related family members who lived together in the same environment had an odds ratio of 1.66 (95% CI, 1.20 to 2.28). Spouses, who are genetically unrelated but live together in the same environment, had an odds ratio of 0.95 (95% CI, 0.60 to 1.59) for cardiac arrest. The risk of cardiac arrest in patients on dialysis may be attributable to inherited factors. Additional studies are needed to identify such candidate genes that modify cardiovascular risk in ESRD.

Keywords: cardiovascular; dialysis; epidemiology and outcomes.

MeSH terms

  • Aged
  • Case-Control Studies
  • Death, Sudden, Cardiac / epidemiology*
  • Family Health
  • Female
  • Genetic Predisposition to Disease*
  • Heart Arrest / complications
  • Heart Arrest / genetics*
  • Humans
  • Kidney Failure, Chronic / complications
  • Kidney Failure, Chronic / diagnosis
  • Kidney Failure, Chronic / genetics*
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Odds Ratio
  • Phenotype
  • Polymorphism, Single Nucleotide
  • Renal Dialysis*
  • Risk Factors
  • Treatment Outcome