SUDDEN-DEATH IN CHRONIC DIALYSIS PATIENTS

Methods. Causes of sudden death were investigated in 113 chronic dialy sis patients who died during the 10-year period from July 1979 to Janu ary 1989; postmortem examination was performed on 93 of the cases (aut opsy rate; 82.3%). Sudden death was regarded as heath 24 h after the o nset of acute illness in patients without any restriction in their dai ly activities. There were 35 sudden death cases out of the 93 autopsie d chronic dialysis patients. We analysed the causes of sudden death fo r all chronic dialysis patients and for those who died suddenly. Resul ts, The mean age of the 93 cases was 61.4 +/- 10.5 years (+/- SD). Str oke was the most frequent cause of death (24 cases, 25.8%) in the 93 a utopsied cases. This was followed by cardiac disease in 18 (19.4%), in fectious disease in 16 (17.2%), malignancy in 14 (15.1%), and dissecti ng aortic aneurysm in 5 (5.4%). The mean age of the 35 sudden death ca ses was 60.9 +/- 10.9 years. Of the 35 sudden death cases in chronic d ialysis 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 myocard ial infarction in two (5.7%), cerebral infarction in two (5.7%), and s ubarachnoidal haemorrhage in one (2.9%), Conclusions, Dissecting aorti c aneurysm, leading frequently to stroke as a cause of sudden death in chronic dialysis patients, at least in Japan, should be carefully dif ferentiated from other cardiac diseases in chronic dialysis patients, such as severe atherosclerosis.