**3.5 Sudden cardiac death**

Sudden cardiac death is held responsible for 62% of the cardiac-related deaths and is usually attributed to arrs (Herzog et al.,2008). The first year of hemodialysis is significant in terms of sudden cardiac deaths and a sudden death was reported in 93 of 1000 patients in the first year (Shastri &Sarnak,2010).

Ischemic heart diseases, cardiomyopathy, fast ion change and electrolyte during hemodialysis, changes in PH, microvascular diseases or endothelial dysfunction are blamed in its pathogenesis (Shastri &Sarnak,2010).

#### **Treatment**

It is the same as in the normal population. It is advisable that an external defibrillator is made available in hemodialysis units and the staff is trained in using it (K/DOQI Workgroup, 2005). There is not adequate data on the use of B blockers (Pun et al.,2007) and internal defibrillators (de Bie et al.,2009).
