Electrocardiographic Changes in Patients Undergoing Hemodialysis

Salari, Arsalan; Mokhtari, Gholamreza; Mirbolook, F; Ganbari, Atefeh; Khosravi, Masoud; Besharati, Sepiedeh; Ghazi, Mohadeseh; Falahatkar, Siavash; Allahkhah, Aliakbar

doi:10.3834/uij.1944-5784.2010.06.03

Cited by 2 publications

(2 citation statements)

References 21 publications

(24 reference statements)

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“…Beyond that, studies that use continuous monitoring such as Holter monitoring instead of ECG recordings at specific time points should be considered. There was also a slight increase of QRS duration at peak stress during HD, in agreement with the results of Salari et al [ 26 ]. Evidence has shown that in both ischemia cardiomyopathy patients and non-ischemia cardiomyopathy patients, abnormal intraventricular conduction is a risk factor for mortality and sudden death [ 27 – 28 ].…”

Section: Discussionsupporting

confidence: 92%

Electrocardiographic Abnormalities and QTc Interval in Patients Undergoing Hemodialysis

Nie¹,

Zou²,

Liang³

et al. 2016

PLoS ONE

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BackgroundSudden cardiac death is one of the primary causes of mortality in chronic hemodialysis (HD) patients. Prolonged QTc interval is associated with increased rate of sudden cardiac death. The aim of this article is to assess the abnormalities found in electrocardiograms (ECGs), and to explore factors that can influence the QTc interval.MethodsA total of 141 conventional HD patients were enrolled in this study. ECG tests were conducted on each patient before a single dialysis session and 15 minutes before the end of dialysis session (at peak stress). Echocardiography tests were conducted before dialysis session began. Blood samples were drawn by phlebotomy immediately before and after the dialysis session.ResultsBefore dialysis, 93.62% of the patients were in sinus rhythm, and approximately 65% of the patients showed a prolonged QTc interval (i.e., a QTc interval above 440 ms in males and above 460ms in females). A comparison of ECG parameters before dialysis and at peak stress showed increases in heart rate (77.45±11.92 vs. 80.38±14.65 bpm, p = 0.001) and QTc interval (460.05±24.53 ms vs. 470.93±24.92 ms, p<0.001). After dividing patients into two groups according to the QTc interval, lower pre-dialysis serum concentrations of potassium (K+), calcium (Ca2+), phosphorus, calcium* phosphorus (Ca*P), and higher concentrations of plasma brain natriuretic peptide (BNP) were found in the group with prolonged QTc intervals. Patients in this group also had a larger left atrial diameter (LAD) and a thicker interventricular septum, and they tended to be older than patients in the other group. Then patients were divided into two groups according to ΔQTc (ΔQTc = QTc peak-stress- QTc pre-HD). When analyzing the patients whose QTc intervals were longer at peak stress than before HD, we found that they had higher concentrations of Ca2+ and P5+ and lower concentrations of K+, ferritin, UA, and BNP. They were also more likely to be female. In addition, more cardiac construction abnormalities were found in this group. In multiple regression analyses, serum Ca2+ concentration before HD and LAD were independent variables of QTc interval prolongation. UA, ferritin, and interventricular septum were independent variables of ΔQTc.ConclusionProlonged QT interval is very common in HD patients and is associated with several risk factors. An appropriate concentration of dialysate electrolytes should be chosen depending on patients’ clinical conditions.

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Section: Discussionsupporting

confidence: 92%

Electrocardiographic Abnormalities and QTc Interval in Patients Undergoing Hemodialysis

Nie¹,

Zou²,

Liang³

et al. 2016

PLoS ONE

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“…Changes in plasma Na, K, and ionized Ca in HD have significant effects on QTcd. 28 Electrocardiogram data demonstrate that the risk of arrhythmia could be higher with decreased plasma Na, K, and decreased ionized Ca during HD. 29 A study showed that hemodialysis increases the QTc interval in ESRD patients, mainly because of rapid changes in plasma electrolyte concentrations 16,30 ; another study indicated that there was no correlation between the changes in QTd and the changes in serum cations.…”

Section: Discussionmentioning

confidence: 99%

QT Intervals in Patients Receiving a Renal Transplant

Monfared

Z²,

Salari³

et al. 2012

Exp Clin Transplant

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Objectives: Cardiovascular disease is the mostcommon cause of mortality in patients with endstage renal disease and renal transplant. Prolongation of QTc max and QTc dispersion are risk factors of cardiac arrhythmias and mortality. This study compares the changes of QT parameters before hemodialysis, after hemodialysis, and after renal transplant. Materials and Methods: Patient candidates for renal transplant were selected. Mean serum electrolyte and 12-lead electrocardiogram were recorded (1) immediately, (2) before and, (3) after the last dialysis session before renal transplant, (4) and 2 weeks after a kidney transplant in 34 patients with normal graft function (plasma Cr ≤ 176.8 µmol/L). Each QT interval was corrected for the patient's heart rate using Bazett's formula. The QT parameters (QTd, QTcd, QTc max ) were compared between prehemodialysis, posthemodialysis, and 2 weeks after renal transplant using a paired t test and a general liner model repeated measure. The correlation between QT parameter changes and serum electrolyte and acidbase alternation was analyzed. Results: The corrected maximal QT interval (QTc max ) decreased significantly after successful renal transplant compared to prehemodialysis (P = .002) and posthemodialysis (P = .003) with a paired t test and a General Liner Model Repeated Measure (P < .001) between the 3 groups. Also, the mean of

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Electrocardiographic Changes in Patients Undergoing Hemodialysis

Cited by 2 publications

References 21 publications

Electrocardiographic Abnormalities and QTc Interval in Patients Undergoing Hemodialysis

Electrocardiographic Abnormalities and QTc Interval in Patients Undergoing Hemodialysis

QT Intervals in Patients Receiving a Renal Transplant

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