McQuillan Rory F, Chan Christopher T
Semin Dial. 2012 Jan-Feb;25(1):15-21. doi: 10.1111/j.1525-139X.2011.01016.x.
Sudden cardiac death (SCD) is common in dialysis patients accounting for up to 25% of all-cause mortality. Unlike in the general population, occlusive coronary artery disease is implicated in a minority of these deaths. Activation of the sympathetic nervous system is prevalent in the dialysis population and may underlie this high rate of SCD. β-blockers reduce SCD in the general population and, given their mode of action, β-blockers would seem to be an ideal class of agents to prevent SCD in dialysis patients. In this review, we will explore the etiology of SCD in dialysis patients and discuss the evidence supporting the use of β-blockers in patients with ESRD. We will also examine potential impediments to the use β-blocker in the dialysis population and outline directions for future trials in this area.
心脏性猝死（SCD）在透析患者中很常见，占全因死亡率的25%。与普通人群不同，闭塞性冠状动脉疾病导致的此类死亡占少数。交感神经系统激活在透析人群中很普遍，可能是SCD发生率高的原因。β受体阻滞剂可降低普通人群的SCD发生率，鉴于其作用方式，β受体阻滞剂似乎是预防透析患者SCD的理想药物类别。在本综述中，我们将探讨透析患者SCD的病因，并讨论支持在终末期肾病（ESRD）患者中使用β受体阻滞剂的证据。我们还将研究在透析人群中使用β受体阻滞剂的潜在障碍，并概述该领域未来试验的方向。
