Seeing Sudden Death on Dialysis

Diabetic dialysis patients have higher risk of sudden cardiac death if they have low homoarginine

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) When a diabetes patient's kidneys fail, that patient has to be put on dialysis. These patients may be at risk of having their heart suddenly stop. Now, researchers have found a way to spot who is most at risk.

Diabetes patients on dialysis who have low levels of homoarginine (a type of amino acid, or building block of protein) are at risk of sudden cardiac death (unexpected death from heart causes) and heart failure death.

"Get your blood checked for homoarginine if you're on dialysis."

Sudden cardiac death is one of the main reasons death rates are so high among patients on dialysis. Past studies have suggested that low levels of homoarginine may decrease levels of nitrous oxide, which may weaken the lining of blood vessels and the heart.

With these past findings in mind, Christiane Drechsler, M.D., Ph.D., from the University of Würzburg in Germany, and colleagues wanted to see if homoarginine could be a risk factor for sudden cardiac death.

The researchers found that diabetic dialysis patients with the lowest levels of homoarginine were more than twice the risk of sudden cardiac death, compared to those with the highest levels of homoarginine. Patients with the lowest levels of homoarginine were also had more than three times the risk of dying from heart failure.

On top of that, low levels of homoarginine seemed to increase the risk of stroke. However, homoarginine did not seem to be a risk factor for heart attack.

The study's authors conclude that diabetic dialysis patients with low homoarginine have a higher risk of both sudden cardiac death and heart failure death. More research is needed, they write, in order to find what it is about low homoarginine that causes these heart-related problems. Once that is done, it may be possible to develop new treatments and interventions for these patients.

They came to these conclusions by studying 1255 diabetes patients on hemodialysis. Throughout the course of the 4-year study, the researchers measured homoarginine levels and looked for cases of sudden cardiac death, heart attack, stroke, heart failure death, and combinations of other heart complications.

The study is published in the European Journal of Heart Failure.

Reviewed by: 
Review Date: 
August 4, 2011
Last Updated:
August 6, 2011