Key result
ICDs show no benefit for primary prevention of SCD in patients with kidney failure.
Why the study?
Sudden cardiac death is a major cause of mortality in dialysis patients, ICDs have failed to show benefit for primary prevention, and complications from cardiac electronic devices are high.
Current evidence does not support the routine use of ICDs for primary prevention of sudden cardiac death in dialysis patients due to lack of proven benefit and high complication rates.
Does not support routine primary-prevention ICDs in kidney failure; leaves open whether refined selection or alternatives merit prospective trials.
Sudden cardiac death is an important cause of mortality in patients with kidney failure undergoing renal replacement therapy, either hemodialysis or peritoneal dialysis. The risk factors associated with sudden cardiac death in these patients only partly overlap with those in the general population. Kidney failure per se and hemodialysis therapy expose these patients to an increased risk of sudden cardiac death compared with individuals with preserved renal function. Studies of the implantable cardioverter defibrillator for primary prevention of sudden cardiac death in patients with kidney failure have failed to demonstrate its usefulness. Moreover, the incidence of complications associated with cardiac electronic device implantation in this population is extremely high. This review aims to provide an update on the available studies on the pathophysiology and prevention of sudden cardiac death in patients with kidney failure undergoing dialysis and to propose the adoption of clinical practices to reduce its incidence.
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Genovesi et al. (2025) conducted a review in Kidney failure on renal replacement therapy. Implantable cardioverter defibrillator was evaluated on Sudden cardiac death. Implantable cardioverter defibrillators for primary prevention of sudden cardiac death in patients with kidney failure have failed to demonstrate usefulness in available studies.
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