Key result
Arrhythmias, particularly bradyarrhythmia, were associated with a significantly increased incidence of sudden cardiac death among dialysis patients (Cohen's d 110.38).
Why the study?
Patients on long-term dialysis have high mortality predominantly from sudden cardiac death linked to arrhythmias, prompting this investigation into the incidence of SCD among dialysis patients at risk of arrhythmia.
Meta-Analysis (n=12,611)
Sudden cardiac death is highly prevalent among dialysis patients, with bradyarrhythmia identified as a common terminal arrhythmic event, underscoring the need for improved risk stratification and monitoring.
Elevates arrhythmia surveillance in dialysis; confirms bradyarrhythmia predominance, extending evidence for targeted SCD prevention trials.
Background Patients on long-term dialysis for end-stage kidney disease have a high mortality rate, predominantly due to sudden cardiac death (SCD), which is associated with an increased risk of arrhythmias compared to the general population. Thus, the current systematic review and meta-analysis aimed to investigate the incidence of SCD among dialysis patients at risk of arrhythmia. Methods This systematic review and meta-analysis followed the PRISMA guidelines. PubMed, Cochrane Library, Google Scholar, Medline, and Europe PMC were searched for articles meeting our inclusion criteria. Studies with risk assessment of arrhythmias and the incidence of SCD in dialysis patients were considered for inclusion. Effect size from eligible studies was pooled using a random effects model and restricted maximum likelihood estimation. Heterogeneity was quantified using the I 2 statistic, and the risk of publication bias was evaluated by visually inspecting funnel plots. Results Our search strategy yielded 5861 studies, of which 1960 duplicate entries were removed in the prescreening stage, 3326 were excluded after title/abstract screening, and 519 after full-text screening for not meeting our inclusion criteria. Finally, 11 studies were included in the analysis, and two more were selected from the bibliography list of previous reviews. Eight included studies were randomized controlled trials, and five were cohort studies, which provided a pooled population size of 12,611 dialysis patients for the meta-analysis, which indicated a significantly larger effect size of arrhythmia [Cohen’s d = 110.38 (95%CI 42.72–178.05), p = 0.0]. Visual assessment of the funnel plot indicated no publication bias. Conclusion SCD remains a significant public health concern, particularly in patients undergoing dialysis. Meta-analysis results show that bradyarrhythmia is a common arrhythmic condition leading to SCD; however, other arrhythmias should also be considered.
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Chander et al. (2025) conducted a meta-analysis in End-stage kidney disease on dialysis (n=12,611). Arrhythmia was evaluated on Incidence of sudden cardiac death (SCD) (Cohen's d 110.38, 95% CI 42.72-178.05, p=0.0). Arrhythmias, particularly bradyarrhythmia, were associated with a significantly increased incidence of sudden cardiac death among dialysis patients (Cohen's d 110.38).
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