Heart Medication Filtered by Dialysis May Increase Premature Death Risk

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Dialysis patients who take highly-dialyzable heart medications such as beta blockers are at an increased risk of premature death compared to those whose heart medications are more difficult to filter, according to a study published in the Journal of the American Society of Nephrology.

Researchers led by Matthew Weir, MD, FRCPC, MSc, from Western University in Ontario, Canada, looked at patient information of dialysis patients based on heart medications. They found that initiation with a highly-dialyzable beta blocker was linked with a 1.4 increased risk of dying within 180 days.

By further analyzing an additional 27,000 patients not on dialysis, they found no difference in mortality between high- and low-dialyzable groups, suggesting that dialysis played an important role in premature death risk.

“Although we can’t draw causal relationships from our observational study, we did see the relationship that we hypothesized,” Dr. Weir noted. “The risk of death was higher in patients whose beta blocker was readily removed from their circulation by hemodialysis.”

He advised that “changing prescriptions from an easily-removed drug to a difficult-to-remove drug might be a simple way to lower the risk of premature death.”

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Dialysis patients who take heart medications at an increased risk of premature death.

Dialysis patients who take heart medications that are easily removed from the circulation through dialysis may be at increased risk of dying prematurely compared with patients whose heart medications are more difficult to remove. The findings come from a study appearing in an upcoming issue of the Journal of the American Society of Nephrology (JASN).

Beta blockers—drugs used to control heart rhythm, treat angina, and reduce high blood pressure—lower the risk of premature death among people with heart disease who are not receiving dialysis. Beta blockers differ in their dialyzability, or the extent to which they are removed through hemodialysis, and experts suspect that if the filtering effects of dialysis remove these important drugs from the circulation, patients can't experience their full benefit.

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