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| |  Dialysis Safe for Patients Who Have Had a Myocardial Infarction WASHINGTON, DC -- July 9, 2009 -- Dialysis treatments do not affect the heart health of patients with kidney disease who have had a myocardial infarction (MI), according to a study published online in the Clinical Journal of the American Society Nephrology (CJASN). Since cardiovascular disease is the most common cause of death in kidney disease patients, the findings are good news for individuals who need the treatments. People with even mild forms of kidney disease have an elevated risk of MI. Those with end-stage renal disease (ESRD) are particularly vulnerable and often experience an MI while undergoing kidney disease treatments such as dialysis. Unfortunately, it is unclear how safe the dialysis procedure is for MI patients. To investigate the issue, George Coritsidis, MD, Elmhurst/Queens Hospital Center, Elmhurst, New York, and colleagues reviewed the medical charts of 131 patients with ESRD who had a heart attack while they were on dialysis. They looked to see if the timing of dialysis had any effect on patients’ heart health following their heart attack. About half of the patients received dialysis within the first 24 hours of their heart attack. A quarter received dialysis 24 to 48 hours after their heart attack, and a quarter received dialysis more than 48 hours after. The researchers found no link between the timing of dialysis treatments and cardiac symptoms such as chest pains or emergency room admissions. A similar number of patients in each of the 3 groups experienced cardiac symptoms. However, the investigators identified several predictors that might indicate which dialysis patients have a particularly high risk of having a heart attack. These include the seriousness of the patient’s condition, prior heart disease, high pre-dialysis potassium blood levels, and a large drop in potassium blood levels after dialysis. “In conclusion, our study does not indicate that timing of dialysis poses a risk. What may be of greater importance is the potassium status, its treatment, and the severity of the patients’ condition on admission,” the authors wrote. “Given that this is a retrospective as well as a small study, we cannot make any clear recommendations, however our findings suggest that rather than delay dialysis, concern should be placed on the degree and rate that potassium levels change.” SOURCE: American Society of Nephrology
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