Dialysis patients with asymptomatic lung congestion are more likely to die prematurely or experience heart attacks or other cardiac events, according to a study in an upcoming issue of the Journal of the American Society of Nephrology (JASN).
Patients with kidney failure who are on dialysis are more prone to lung congestion due to fluid accumulation, but they often do not display symptoms. A group of Italian researchers sought to identify whether asymptomatic congestion affects dialysis patients’ health. They used lung ultrasound to measure the presence and severity of lung congestion in 392 dialysis patients.
Researchers found 14 percent of patients had very severe congestion and 45 had moderate-to-severe lung congestion. Among the latter group, 71 percent were asymptomatic. Compared to those with mild or no congestion, patients with very severe congestion had a 4.2-fold increased risk of dying and a 3.2-fold increased risk of experiencing heart attacks or other cardiac events over a two-year follow-up period.
“Our findings generate the hypothesis that targeting subclinical pulmonary (lung) congestion may improve cardiovascular health and reduce risk from cardiovascular death in the dialysis population, a population at an extremely high risk,” said Dr. Carmine Zoccali, author of the study. He suggested that fluid in the lungs may be reduced with longer and/or more frequent dialysis.
A clinical trial will be initiated that will incorporate lung fluid measurements using ultrasound to test whether dialysis intensification in patients with asymptomatic lung congestion can prevent premature death and reduce the risk of heart failure and cardiac events.
Coincidentally, Fresenius Medical Care, the world’s provider of dialysis services, is facing several wrongful death lawsuits alleging that one of its dialysis products caused sudden cardiac death in patients. The company is being accused of withholding from the Food and Drug Administration (FDA) and its customers (including other dialysis clinics and patients) information about the serious health risks associated with its GranuFlo dialysis concentrate and a similar product, NaturaLyte.
The products contain an ingredient that metabolizes in the body into a substance known as bicarbonate. The products contain higher levels of this ingredient that competitor products. High levels of bicarbonate can increase the risk for cardiac events including sudden cardiac death.
Source: News Medical