NDT Advance Access originally published online on May 23, 2008
Nephrology Dialysis Transplantation 2008 23(10):3061-3062; doi:10.1093/ndt/gfn280
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© The Author [2008]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org
Heart rate variability in patients with end-stage renal disease: an emerging predictive tool for sudden cardiac death?
Division of Nephrology, Department of Medicine, Toronto General Hospital—University Health Network, University of Toronto, Toronto, Canada
Christopher T. Chan, Toronto General Hospital, 200 Elizabeth Street, 8N room 842, Toronto, Ontario M5G 2C4, Canada. Tel: +1-416-340-3073; Fax: +1-416-340-4999; E-mail: christopher.chan@uhn.on.ca
Keywords: fluid overload; heart rate variability; sudden cardiac death; sympathetic overactivity
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Patients with end-stage renal disease (ESRD) have an elevated cardiovascular mortality. Although much interest has been focused on the understanding of the accelerated nature of their coronary artery disease, sudden cardiac death (SCD) has emerged as the single largest cause of cardiac death in our patient population. Multiple traditional and novel cardiovascular risk factors contribute to the particular vulnerability of dialysis patients towards SCD, including myocardial ischaemia, left ventricular hypertrophy/dilatation, electrolytes abnormalities, volume overload, sleep apnoea and sympathetic overactivity [1]. Despite our best