Sudden Death, A Common Cause of Death in Japanese Hemodialysis Patients

[See article vol.27:306-318] There is a large difference in the reported cause of cardiac death in dialysis patients between Japan and other countries. In Japan, 26% of deaths are due to heart failure and only 2.5% of deaths are caused by sudden cardiac death (SCD), whereas in the United States, 28% of deaths are caused by SCD and only 4% of deaths are due to heart failure, according to the national data in both countries. Thus, the major cause of cardiac death in Japan is heart failure, whereas it is SCD in the United States, one of the leading countries for dialysis medicine in the world. One of the reasons for this big difference may be no currently established and accepted definition of SCD in the clinical setting. A recent meta-analysis analyzing the incidence of SCD in patients with end-stage kidney disease clearly showed a complicated situation, wherein the definition of SCD varied among the 43 included studies.