Electrocardiographic abnormalities among late-stage non-dialysis chronic kidney disease patients

Abstract

ObjectivesCardiovascular disease (CVD) complication is common among chronic kidney disease (CKD) patients. Thus, knowledge about CVD and ECG abnormalities in CKD are essential due to progressive nature of the disease and increased risk of sudden cardiac death. This study aims to scrutinize the ECG abnormalities among nondialysis late-stage CKD patients.MethodsA descriptive observational study was conducted at Dr. Soetomo General Hospital, Surabaya, Indonesia. Subjects were hospitalized patients with late-stage CKD between 1 January and 31 December 2019, who were consulted at the department of cardiology and vascular medicine during their initial admission at emergency room. ECG interpretation for this study was done by qualified cardiologist.ResultsThere were 191 patients included in this study. Mean ages were 52.2 ± 11.8 years old and 51% were males. Total 143 (74.9%) patients had anemia, 111 (58.1%) had hypertension and 75 (39.3%) had type 2 diabetes mellitus. Mean serum creatinine was 10.5 ± 8.0 mg/dL. There were 176 (92.1%) patients with at least one form of ECG abnormalities. Prolonged QTc interval (36.6%), fragmented QRS complex (29.8%), poor R wave progression (24.6%), peaked T wave (22.0%) and left ventricular hypertrophy (16.7%) were the most common abnormalities.ConclusionsECG abnormalities are common among nondialysis late-stage CKD patients. Given the fact that long-term CKD influences the pathogenesis cardiovascular diseases and substantial cardiovascular mortality, there is a need to screen Indonesian CKD patients who are at risks of getting earlier complications.

Efficacy and Mechanism of Roxadustat plus Oral Iron in the Treatment of Elderly Chronic Kidney Disease with Anemia

“…Clinically, anemia is characterized by reduced volume of human peripheral red blood cells [ 8 ], and is associated with weakened immune function, and in severe cases, it myocardial dysfunction and lack of oxygen in severe cases [ 9 , 10 ]. EPO is an active glycoprotein secreted by the human kidney, which can stimulate the proliferation of red blood cells through binding to EPO receptors on the surface of red blood cells.…”

“…Also, anemia is associated with low immune function, myocardial damage, and hypoxia. Modern medicine believes that the decreased secretion of erythropoietin (EPO) produced by the kidneys, insufficient raw materials such as iron and folic acid and the inhibition of bone marrow hematopoiesis are contributors to CKD with anemia [ 9 , 10 ]. EPO is an active glycoprotein secreted by the kidney, which stimulates erythrocyte proliferation through binding to EPO receptors on the surface of erythrocytes.…”

Chronic Kidney Disease and Heart Failure–Everyday Diagnostic Challenges

“…However, for patients with previously diagnosed CKD, the usefulness of the HF diagnostic algorithm currently proposed may be considered questionable [1] (Figure 2). [1,[10][11][12][13][14][15][16][17]. The HF diagnostic algorithm (left) includes symptoms that are common in patients with CKD, with or without HF (center).…”

Electrocardiographic Abnormalities in Patients with Hyperkalemia: A Retrospective Study in an Emergency Department in Colombia

“…This may explain a greater tolerance to hyperkalemia and fewer abnormal changes in the ECGG. 34 , 35…”

“…This may explain a greater tolerance to hyperkalemia and fewer abnormal changes in the ECGG. 34,35 Mulia et al described the most common ECG abnormalities were the prolonged QTc interval (36.6%), fragmented QRS complex (29.8%), poor R wave progression (24.6%), and peaked T wave (22%). 27 Powell et al demonstrated no difference in ECG changes between acute and chronic hyperkalemic groups.…”