| Theme |
Heart and it's Diseases in Dialysis Patients -- For their better longevity |
| Title |
Arrhythmia in hemodialysis patients |
| Author |
Tetsuya Ogawa |
Department of Medicine, Kidney Center, Tokyo Women's Medical University |
| Author |
Tetsuri Yamashita |
Department of Medicine, Kidney Center, Tokyo Women's Medical University |
| Author |
Kosaku Nitta |
Department of Medicine, Kidney Center, Tokyo Women's Medical University |
| [ Summary ] |
In hemodialysis patients, arrhythmias are common disease condition and sudden death rates are high. This is due to a high prevalence rate for hypertrophy and ischemic heart diseases in these patients, as compared to patients with other underlying diseases. These conditions are due to acute changes in body fluid volume, electrolyte balance and acid-base balance. In renal failure, pathogenesis factors related to arrhythmia, activate renin-angiotensin-aldosteron system and the sympathetic nerve system. Cardiac hypertrophy and interstitial fibrosis are due to these factors. Upstream therapies, which could be used to treat these basic pathogenic factors associatied with arrhythmia, have been suggested as opposed to downstream therapies, which may be implemented by using antiarrhythmic drugs. Dosages of some antiarrhythmic drugs should be reduced for patients with kidney metabolism complications but should not be reduced for patients with liver metabolism. It is important to correct for body fluid volume, electrolyte balance, acid-base balance, anemia, and high blood pressure while at the same time, using appropriate antiarrhythmic drugs. |