Changes in QT Interval in Maintenance Hemodialysis Patients: Pre-Dialysis, One Hour after Initiation of Dialysis, and Post-Dialysis

Log in to MyKarger to check if you already have access to this content.

Buy FullText & PDF Unlimited re-access via MyKarger Unrestricted printing, no saving restrictions for personal use read more

CHF 38.00 *
EUR 35.00 *
USD 39.00 *

Select

KAB

Buy a Karger Article Bundle (KAB) and profit from a discount!

If you would like to redeem your KAB credit, please log in.

Save over 20% compared to the individual article price.

Learn more

Rent via DeepDyve Unlimited fulltext viewing of this article Organize, annotate and mark up articles Printing and downloading restrictions apply

Start free trial

Subscribe Access to all articles of the subscribed year(s) guaranteed for 5 years Unlimited re-access via Subscriber Login or MyKarger Unrestricted printing, no saving restrictions for personal use read more

Subcription rates

Select

* The final prices may differ from the prices shown due to specifics of VAT rules.

Article / Publication Details

First-Page Preview

Abstract of Hemodialysis – Research Article

Received: November 27, 2022
Accepted: February 07, 2023
Published online: March 30, 2023

Number of Print Pages: 9
Number of Figures: 3
Number of Tables: 5

ISSN: 0253-5068 (Print)
eISSN: 1421-9735 (Online)

For additional information: https://www.karger.com/BPU

Abstract

Introduction: This study aimed to evaluate the effects of dialysis on change of QT interval in pre-dialysis, 1 h after dialysis initiation, and post-dialysis period in patients on maintenance dialysis (MHD). Methods: An observational prospective study was conducted, including 61 patients, on thrice-weekly MHD ≥3 months, and without acute diseases, at the Nephrology-Dialysis Department of a tertiary hospital in Vietnam. The exclusive criteria were atrial fibrillation, atrial flutter, branch block, prolonged QT recorded in medical history, and taking antiarrhythmic drugs lengthening QT interval before entering the study. Twelve-lead electrocardiographs and blood chemistries were done simultaneously before, 1 h after initiation, and after the dialysis session. Results: The proportion of patients with prolonged QT interval increased significantly from 44.3% in pre-dialysis to 77% 1 h after dialysis initiation and 86.9% in post-dialysis session. Immediately after dialysis, the QT and QTc intervals on all 12 leads were significantly longer. Post-dialysis levels of potassium, chloride, magnesium, and urea decreased significantly from 3.97 (0.7), 98.6 (4.7), 1.04 (0.2), and 21.4 (6.1) to 2.78 (0.4), 96.6 (2.5), 0.87 (0.2), and 6.33 (2.8) mmol/L, respectively, whereas the calcium increased significantly from 2.19 (0.2) to 2.57 (0.2) mmol/L. There were significant differences in the potassium level at the dialysis initiation and its speed of reduction between the group without and with prolonged QT interval. Conclusions: There was an increased risk of prolonged QT interval in MHD patients regardless of the absence of the previous abnormal QT interval. Notably, this risk increased rapidly 1 h after the initiation of dialysis.

© 2023 S. Karger AG, Basel

References GBD Chronic Kidney Disease Collaboration. Global, regional, and national burden of chronic kidney disease, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2020;395(10225):709–33. Beaubien ER, Pylypchuk GB, Akhtar J, Biem HJ. Value of corrected QT interval dispersion in identifying patients initiating dialysis at increased risk of total and cardiovascular mortality. Am J Kidney Dis. 2002;39(4):834–42. Epub 2002 Mar 29. Collins AJ, Foley RN, Gilbertson DT, Chen SC. United States Renal Data System public health surveillance of chronic kidney disease and end-stage renal disease. Kidney Int Suppl. 20112015;5(1):2–7. Epub 2015 Jun 23. Liu P, Wang L, Han D, Sun C, Xue X, Li G. Acquired long QT syndrome in chronic kidney disease patients. Ren Fail. 2020;42(1):54–65. Epub 2019 Dec 28. Howse M, Sastry S, Bell GM. Changes in the corrected QT interval and corrected QT dispersion during haemodialysis. Postgrad Med J. 2002;78(919):273–5. Epub 2002 Aug 02. Kanbay M, Afsar B, Goldsmith D, Covic A. Sudden death in hemodialysis: an update. Blood Purif. 2010;30(2):135–45. Epub 2010 Aug 28. Malik R, Waheed S, Parashara D, Perez J, Waheed S. Association of QT interval with mortality by kidney function: results from the National Health and Nutrition Examination Survey (NHANES). Open Heart. 2017;4(2):e000683. Epub 2017 Oct 10. Malhis M, Al-Bitar S, Farhood S, Zaiat KA. 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. Epub 2010 Apr 30. Praveenkumar I, Kusubi DN. A comparative study to evaluate the effect of hemodialysis on maximum corrected QT interval (QTcmax) and QT dispersion in chronic kidney disease. Eur J Biomed Pharm Sci. 2019;6(5):359–62. Sohal PM, Goel A, Gupta D, Aslam N, Sandhu J, Sandhu JS, et al. Effect of hemodialysis on corrected QT interval and QTc dispersion. Indian J Nephrol. 2018;28(5):335–8. National Kidney Foundation. KDOQI Clinical practice guidelines for hemodialysis adequacy: update 2000. Am J Kidney Dis. 2001;37(1 Suppl 1):S7–64. Epub 2001 Mar 7. Johnson JN, Ackerman MJ. QTc: how long is too long? Br J Sports Med. 2009;43(9):657–62. Epub 2009 Sep 8. Bazett HC. An analysis of the time-relations of electrocardiograms. Ann Noninvasive Electrocardiol. 1997;2(2):177–94. Di Iorio B, Torraca S, Piscopo C, Sirico ML, Di Micco L, Pota A, et al. Dialysate bath and QTc interval in patients on chronic maintenance hemodialysis: pilot study of single dialysis effects. J Nephrol. 2012;25(5):653–60. Epub 2011 Oct 11. Rautaharju PM, Surawicz B, Gettes LS, Bailey JJ, Childers R, Deal BJ, et al. AHA/ACCF/HRS recommendations for the standardization and interpretation of the electrocardiogram: part IV: the ST segment, T and U waves, and the QT interval: a scientific statement from the American heart association electrocardiography and arrhythmias committee, council on clinical cardiology; the American college of cardiology foundation; and the heart rhythm society. Endorsed by the international society for computerized electrocardiology. J Am Coll Cardiol. 2009;53(11):982–91. Epub 2009 Mar 14. Lorincz I, Mátyus J, Zilahi Z, Kun C, Karányi Z, Kakuk G. QT dispersion in patients with end-stage renal failure and during hemodialysis. J Am Soc Nephrol. 1999;10(6):1297–302. Epub 1999 Jun 11. Kim ED, Watt J, Tereshchenko LG, Jaar BG, Sozio SM, Kao WH, et al. Associations of serum and dialysate electrolytes with QT interval and prolongation in incident hemodialysis: the Predictors of Arrhythmic and Cardiovascular Risk in End-Stage Renal Disease (PACE) study. BMC Nephrol. 2019;20(1):133. Epub 2019 Apr 20. Matsumoto Y, Mori Y, Kageyama S, Arihara K, Sato H, Nagata K, et al. Changes in QTc interval in long-term hemodialysis patients. PLoS One. 2019;14(1):e0209297. Epub 2019 Jan 04. Genovesi S, Dossi C, Vigano MR, Galbiati E, Prolo F, Stella A, et al. Electrolyte concentration during haemodialysis and QT interval prolongation in uraemic patients. Europace. 2008;10(6):771–7. Epub 2008 Feb 22. Makar MS, Pun PH. Sudden cardiac death among hemodialysis patients. Am J Kidney Dis. 2017;69(5):684–95. Epub 2017 Feb 23. Rombolà G, Colussi G, De Ferrari ME, Frontini A, Minetti L. Cardiac arrhythmias and electrolyte changes during haemodialysis. Nephrol Dial Transplant. 1992;7(4)318–22. Epub 1992 Jan 1. Näppi SE, Virtanen VK, Saha HH, Mustonen JT, Pasternack AI. QTc dispersion increases during hemodialysis with low-calcium dialysate. Kidney Int. 2000;57(5):2117–22. Roden DM. Drug-induced prolongation of the QT interval. N Engl J Med. 2004;350(10):1013–22. Epub 2004 Mar 5. Sacher F, Jesel L, Borni-Duval C, De Precigout V, Lavainne F, Bourdenx JP, et al. Cardiac rhythm disturbances in hemodialysis patients: early detection using an implantable loop recorder and correlation with biological and dialysis parameters. JACC Clin Electrophysiol. 2018;4(3):397–408. Genovesi S, Valsecchi MG, Rossi E, Pogliani D, Acquistapace I, De Cristofaro V, et al. Sudden death and associated factors in a historical cohort of chronic haemodialysis patients. Nephrol Dial Transplant. 2009;24(8):2529–36. Jadoul M, Thumma J, Fuller DS, Tentori F, Li Y, Morgenstern H, et al. Modifiable practices associated with sudden death among hemodialysis patients in the Dialysis Outcomes and Practice Patterns Study. Clin J Am Soc Nephrol. 2012;7(5):765–74. Epub 2012 Mar 8. Jebali H, Ghabi H, Mami I, Hassan M, Ben Kaab B, Chermiti M, et al. SP553 corrected QT interval and QT dispersion in patients undergoing hemodialysis. Nephrol Dial Transplant. 2019;34(Suppl 1):gfz103SP553. Sabzghabaei F, Heydariezade SA, Joodat RS. The effects of different electrolyte composition in dialysate on QTc interval; a controlled trial. J Ren Inj Prev. 2016;5(3):153–6. Article / Publication Details

First-Page Preview

Abstract of Hemodialysis – Research Article

Received: November 27, 2022
Accepted: February 07, 2023
Published online: March 30, 2023

Number of Print Pages: 9
Number of Figures: 3
Number of Tables: 5

ISSN: 0253-5068 (Print)
eISSN: 1421-9735 (Online)

For additional information: https://www.karger.com/BPU

留言 (0)

沒有登入
gif