Over 20 million Americans, or about 13% of the population, suffer from CKD, and 485,000 of them have end-stage renal disease (ESRD), which necessitates renal replacement treatment. Increased cardiovascular mortality is independently linked to moderate renal dysfunction. At least 25% of deaths from chronic kidney disease are caused by sudden cardiac arrest. Thus, this study was set to assess how mild CKD affected the risk of SCA.
From February 1, 2002, to December 31, 2020, researchers carried out a case-control research as part of a community-based assessment of SCA in the Portland, Oregon. Creatinine levels were assessed before to SCA/enrollment in both cases (individuals aged 40–75 years) and controls (individuals without a history of SCA). According to the Chronic Kidney Disease Epidemiology Collaboration calculation from 2021, a glomerular filtration rate of 30 to less than 60 mL/min per 1.73 m2 was considered to be indicative of moderate CKD.
A total of 852 controls and 2068 SCA cases were compared, where the mean ages of controls were 61.4±8.5 and 62.7±8.0 years, respectively. The men's ages were 69.9% and 67.4%. When compared to controls, SCA patients had lower estimated glomerular filtration rates (74.7 compared 80.9 mL/min per 1.73 m2, P<0.001) and more mild CKD (17.7% against 14.7%, P<0.001).
Moderate CKD was shown to be an independent risk factor for SCA by multivariable regression (odds ratio, 1.32 [95% CI, 1.02–1.71]). This raised the risk of SCA by 10 mL/min every 1.73 m2 estimated glomerular filtration rate decline to <90 (odds ratio, 1.24 [95% CI, 1.18–1.31]). Moderate CKD was linked to SCA in the validation cohort (817 SCA and 3249 controls) with similar results (odds ratio, 1.54 [95% CI, 1.18–2.00]).
Overall, in the general population, moderate CKD is linked to a higher risk of SCA. The risk of SCA was 32% to 54% greater in those with an eGFR of 30 to less than 60 mL/min/1.73 m². The risk increased by 24% for every 10 mL/min drop in eGFR below 90, highlighting the need to account for even mild renal impairment when assessing the risk of SCA.
Source:
Truyen, T. T. T. T., Uy-Evanado, A., Chugh, H., Reinier, K., Charytan, D. M., Salvucci, A., Jui, J., & Chugh, S. S. (2025). Moderate kidney dysfunction independently increases sudden cardiac arrest risk: A community-based study. Journal of the American Heart Association, e042307. https://doi.org/10.1161/JAHA.125.042307
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