Prevalence and Predictors of Arrhythmia in End Stage Renal Disease Patients on Hemodialysis

Bozbaş, Hüseyin; Atar, İlyas; Yildirir, Aylin; Ozgül, Aliseydi; Uyar, Murathan; Özdemir, Nurhan; Müderrisoğlu, Haldun; Özin, Bülent

doi:10.1080/08860220701191237

Cited by 47 publications

(33 citation statements)

References 37 publications

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“…In accordance with our study, Bozbas et al have shown that duration of dialysis therapy is an independent factor affecting ventricular arrhythmia development in these patients (33).…”

Section: Türk Nefroloji Diyaliz Ve Transplantasyon Dergisi Turkish Nesupporting

confidence: 79%

Tp-e/QT and Tp-e/QTc Ratio in Hemodialysis and Peritoneal Dialysis Patients

Güçlü¹,

Sipahioğlu²,

Icli³

et al. 2016

Turk Neph Dial Transpl

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OBJECTIVE: Sudden cardiac death and risk of arrhythmia are higher in patients with ESRD. Tp-e/ QT, and Tp-e/QTc are novel and more reliable indexes of ventricular arrhythmogenesis and sudden cardiac death than QTc. The aim of this study was to assess ventricular repolarization in patients with hemodialysis and peritoneal dialysis by using the Tp-e interval, Tp-e/QT ratio, and Tp-e/QTc ratio. MATERIAL and METHODS:A total of 35 healthy controls, 92 hemodialysis patients, and 104 peritoneal dialysis patients were enrolled in the study. The Tp-e interval, Tp-e/QT, and Tp-e/QTc ratio were calculated from the ECGs of the individuals and compared among groups. RESULTS:QT value was significantly higher in hemodialysis group compared with peritoneal dialysis group (p<0.001) and control group (p<0.001). However a difference was not found comparing QT values between peritoneal dialysis and control groups. Tp-e, Tp-e/QTc, Tp-e/QT, and QTc values were significantly higher in hemodialysis and peritoneal dialysis group comparing to control group. However a statistically significant difference was not found while comparing QTc values between peritoneal dialysis and control groups (p:0.081). When all patients of ESRD without DM were compared with the control group, Tp-e, Tp-e/QTc, Tp-e/QT, and QTc values were found significantly higher than the healthy control group. The values of Tp-e/QT (p<0.001 r:0.314) and Tp-e/QTc (p:0.018 r:0,187) in all patients with kidney disease were found to show positive correlation with duration of dialysis (month). CONCLUSION:This is the first known study that shows Tp-e/Q, and Tp-e/QTc are higher in hemodialysis and peritoneal dialysis patients. KEy wORDS:Tp-e/QT, Tp-e/QTc, Tp-e, QTc, Dialysis Öz AMAÇ: Ani kardiyak ölüm ve aritmi riski son dönem böbrek yetmezliği hastalarında yüksektir. Tp-e/ QT, ve Tp-e/QTc' nin ventriküler aritmogenezisi ve ani kardiyak ölümü göstermede QTc' den daha değerli olduğu gösterilmiştir. Çalışmada amacımız hemodiyaliz ve periton diyalizi hastalarında Tp-e intervali, Tp-e/QT ve Tp-e/QTc oranını kullanarak ventriküler repolarizasyonu değerlendirmektir. GEREÇ ve yÖNTEMLER:35 sağlıklı kontrol, 92 hemodiyaliz hastası, ve 104 periton diyalizi hastası çalışmaya dahil edildi. Bütün hastaların elektrokardiyografileri çekildi. Tp-e interval, Tp-e/QT ve Tp-e/ QTc oranı elektrokardiyografiden elde edilen verilerle hesaplandı ve gruplar arasında karşılaştırıldı. BULGULAR:QT hemodiyaliz hastalarında periton diyalizi hastalarına (p<0,001) ve sağlıklı kontrollere (p<0,001) göre yüksek saptandı. Ancak QT periton diyalizi hastalarında sağlıklı kontrollere göre anlamlı fark saptanmadı. QTc, Tp-e, Tp-e/QT, ve Tp-e/QTc hemodiyaliz ve periton diyalizi hastalarında sağlıklı kontrollere göre anlamlı yüksek tespit edildi. Bununla birlikte periton diyalizi ve kontrol grupları arasında QTc değerleri arasında farklılık tespit edilmedi (p:0,081). Diyabetik olmayan bütün son dönem böbrek yetmezliği hastaları sağlıklı kontrollerle karşılaştırıldığında QTc, Tp-e, Tp-e/ QT, ve Tp-e/QTc sağlıkl...

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“…In accordance with our study, Bozbas et al have shown that duration of dialysis therapy is an independent factor affecting ventricular arrhythmia development in these patients (33).…”

Section: Türk Nefroloji Diyaliz Ve Transplantasyon Dergisi Turkish Nesupporting

confidence: 79%

Tp-e/QT and Tp-e/QTc Ratio in Hemodialysis and Peritoneal Dialysis Patients

Güçlü¹,

Sipahioğlu²,

Icli³

et al. 2016

Turk Neph Dial Transpl

View full text Add to dashboard Cite

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“…ectopy in the form of PVCs and CVAs is increased during HD, which is consistent with previously published evidence. [21,22] More significantly, we have demonstrated a significantly higher frequency of PVCs during HD in those patients who develop dialysis-induced acute cardiac injury (in the form of RWMAs).…”

Section: Discussionmentioning

confidence: 87%

Hemodialysis-Induced Left Ventricular Dysfunction Is Associated with an Increase in Ventricular Arrhythmias

et al. 2008

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Conventional hemodialysis results in intradialytic cardiac ischemia in a significant proportion of patients. Segmental myocardial ischemia results in the development of left ventricular regional wall motion abnormalities. Sudden death is the most common cause of mortality in hemodialysis patients. This study looked to examine any association between the development of left ventricular regional wall motion and cardiac arrhythmias. Forty established hemodialysis patients had 24-hour Holter recordings, which commenced immediately before a dialysis session. Frequency of isolated ectopy was classified as a percentage of the total beats on the Holter monitor record. Ventricular arrhythmias were stratified according to the Lown classification. Classes 3 and above were taken as complex ventricular arrhythmias. Patients also underwent baseline and intradialytic echocardiography to assess the development of concurrent regional wall motion abnormalities. Premature ventricular complexes and complex ventricular arrhythmias were both more common during hemodialysis than in the subsequent monitored period. Patients who developed regional wall motion abnormalities (n = 27) had significantly more premature ventricular complexes during hemodialysis than afterward ( p < 0.001). Patients with ischemic heart disease and left ventricular hypertrophy both had a higher frequency of premature ventricular complexes during hemodialysis than those without ( p < 0.03 and p < 0.02, respectively).Cardiac arrhythmias are common in hemodialysis patients. The frequency of premature ventricular complexes is significantly higher during hemodialysis in patients who develop regional wall motion abnormalities and may be related to factors associated with demand ischemia.

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“…16,[22][23] Arrhythmias are frequently observed in ESRD patients receiving hemodialysis and may be because of the high rate of sudden deaths. 10,16,[24][25] On the other hand, QT dispersion has become useful for predicting and evaluating ventricular arrhythmias. 26 Patients with long QT intervals have more frequent ventricular premature beats and sudden death than those with normal QT intervals.…”

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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Prevalence and Predictors of Arrhythmia in End Stage Renal Disease Patients on Hemodialysis

Cited by 47 publications

References 37 publications

Tp-e/QT and Tp-e/QTc Ratio in Hemodialysis and Peritoneal Dialysis Patients

Tp-e/QT and Tp-e/QTc Ratio in Hemodialysis and Peritoneal Dialysis Patients

Hemodialysis-Induced Left Ventricular Dysfunction Is Associated with an Increase in Ventricular Arrhythmias

QT Intervals in Patients Receiving a Renal Transplant

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