Changes in QT Interval Before and After Hemodialysis

Overview

Journal Caspian J Intern Med

Specialty General Medicine

Date 2013 Sep 7

PMID 24009942

Citations 10

Authors

Mohammad Reza Khosoosi Niaki

Mehrdad Saravi

Farshid Oliaee

Roghayeh Akbari

Sepideh Noorkhomami

Seyed Hassan Bozorgi Rad

Kobra Fallahpoor

Mir Saeed Ramezani

Affiliations

Soon will be listed here.

Abstract

Unlabelled: Background : Cardiovascular mortality and morbidity are high in chronic renal failure (CRF) patients. Increased dispersion of QT intervals is known to predispose to ventricular arrhythmias and sudden cardiac death. This study was conducted to assess the effect of hemodialysis (HD) on corrected QT (QTc) intervals and their dispersions (QTd) in chronic hemodialyzed patients.

Methods: Fifty-eight patients ( mean age 54.2±15.8 years) with chronic renal disease on chronic hemodialysis (HD) were assessed by standard examination including blood pressure, body weight, heart rate, 12-lead electrocardiography and laboratory tests like electrolytes (Na (+), K (+), Ca (++), phosphate), urea, and creatinine 30 minutes before and after HD. The QT intervals and QTc QTc= QT √R-R/ (in milli seconds [ms]) for each lead were measured manually by one observer using calipers. The difference between the maximum and the minimum of QT interval was noted as QT dispersion (QT d).

Results: The mean of pre and post dialysis R-R intervals was 859.22±96.85 ms and 870.43±91.45 ms, respectively (p>0.05). The mean of corrected QT cmax intervals increased significantly from 423.45±24.10 to 454.41±30.25 ms (p<0.05). The mean of QT dispersions and the corrected QT interval dispersions changed from 51.56±12.45 to 63.21±14.43 ms (p<0.05) from 59.40±13.58 to 68.33±14.55 ms (p<0.05), respectively. The changes in serum potassium and calcium levels were related with QT interval prolongation.

Conclusion: QT and QTc interval and dispersion increase in HD patients. Prolonged QT interval indices had relation with K(+) and Ca(++) ions before but not after HD.

Citing Articles

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Fibroblast growth factor 23 (FGF23) induces ventricular arrhythmias and prolongs QTc interval in mice in an FGF receptor 4-dependent manner.

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Acquired long QT syndrome in chronic kidney disease patients.

Liu P, Wang L, Han D, Sun C, Xue X, Li G Ren Fail. 2019; 42(1):54-65.

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References

Buemi M, Coppolino G, Bolignano D, Sturiale A, Campo S, Buemi A . Arrhythmias and hemodialysis: role of potassium and new diagnostic tools. Ren Fail. 2009; 31(1):75-80. DOI: 10.1080/08860220802546495. View

Murasawa T, Sakai Y, Sakai S, Ohtsuka T, Ohno D, Amitani K . [QT dispersion increases during hemodialysis procedures in patients undergoing maintenance dialysis: association with an RA system and holter electrocardiogram]. Nihon Jinzo Gakkai Shi. 2008; 50(4):481-7. View

Di Iorio B . Relevance of QT dispersion in haemodialysis patients. Nephrol Dial Transplant. 2010; 25(4):1357-9. DOI: 10.1093/ndt/gfp701. View

Garadah T, Kassab S, Mahdi N, Abu-Taleb A, Jamsheer A . QTc Interval and QT Dispersion in Patients with Thalassemia Major: Electrocardiographic (EKG) and Echocardiographic Evaluation. Clin Med Insights Cardiol. 2010; 4:31-7. PMC: 2884339. DOI: 10.4137/cmc.s4472. View

Malhis M, Al-Bitar S, Farhood S, Zaiat K . Changes in QT intervals in patients with end-stage renal disease before and after hemodialysis. Saudi J Kidney Dis Transpl. 2010; 21(3):460-5. View

Drighil A, Madias J, El Mosalami H, El Badaoui N, Bennis A, Mouine B . Determinants of augmentation of ECG QRS complexes and R waves in patients after hemodialysis. Ann Noninvasive Electrocardiol. 2007; 12(2):111-20. PMC: 6932171. DOI: 10.1111/j.1542-474X.2007.00149.x. View

Zabel M, Portnoy S, Franz M . Electrocardiographic indexes of dispersion of ventricular repolarization: an isolated heart validation study. J Am Coll Cardiol. 1995; 25(3):746-52. DOI: 10.1016/0735-1097(94)00446-W. View

Covic A, Diaconita M, Gusbeth-Tatomir P, Covic M, Botezan A, Ungureanu G . Haemodialysis increases QT(c) interval but not QT(c) dispersion in ESRD patients without manifest cardiac disease. Nephrol Dial Transplant. 2002; 17(12):2170-7. DOI: 10.1093/ndt/17.12.2170. View

Voroneanu L, Covic A . Arrhythmias in hemodialysis patients. J Nephrol. 2009; 22(6):716-25. View

10.

Herzog C, Mangrum J, Passman R . Sudden cardiac death and dialysis patients. Semin Dial. 2008; 21(4):300-7. DOI: 10.1111/j.1525-139X.2008.00455.x. View

11.

Voulgari C, Moyssakis I, Perrea D, Kyriaki D, Katsilambros N, Tentolouris N . The association between the spatial QRS-T angle with cardiac autonomic neuropathy in subjects with Type 2 diabetes mellitus. Diabet Med. 2010; 27(12):1420-9. DOI: 10.1111/j.1464-5491.2010.03120.x. View

12.

Wu V, Lin L, Wu K . QT interval dispersion in dialysis patients. Nephrology (Carlton). 2005; 10(2):109-12. DOI: 10.1111/j.1440-1797.2005.00391.x. View

13.

Cobo Sanchez J, Alconero Camarero A, Casaus Perez M, Maza Sota M, Villa Llamazares C, Hiquera Roldan C . Hyperkalaemia and haemodialysis patients: eletrocardiographic changes. J Ren Care. 2009; 33(3):124-9. DOI: 10.1111/j.1755-6686.2007.tb00057.x. View

14.

Watanabe H, Watanabe T, Sasaki S, Nagai K, Roden D, Aizawa Y . Close bidirectional relationship between chronic kidney disease and atrial fibrillation: the Niigata preventive medicine study. Am Heart J. 2009; 158(4):629-36. DOI: 10.1016/j.ahj.2009.06.031. View

15.

Sniderman A, Solhpour A, Alam A, Williams K, Sloand J . Cardiovascular death in dialysis patients: lessons we can learn from AURORA. Clin J Am Soc Nephrol. 2010; 5(2):335-40. DOI: 10.2215/CJN.06300909. View

16.

Crisu D . [Sudden death and ventricular arrhythmias risk stratification after myocardial infarction]. Rev Med Chir Soc Med Nat Iasi. 2010; 114(1):13-9. View