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PLoS One. 2019 Jan 3;14(1):e0209297. doi: 10.1371/journal.pone.0209297. eCollection 2019.

Changes in QTc interval in long-term hemodialysis patients.

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Department of Nephrology and Hemodialysis, Shizuoka City Hospital, Shizuoka, Japan.
Shibukawa Clinic, Shizuoka, Japan.
Kageyama Clinic, Shizuoka, Japan.
Ohtemachi Clinic, Shizuoka, Japan.
Sawada Hospital, Gifu, Japan.
Sugiyama Clinic, Shizuoka, Japan.



Cardiovascular diseases, including sudden cardiac death (SCD), are the leading cause of death in hemodialysis (HD) patients. A prolonged QT interval on the electrocardiogram (ECG) is a risk factor for SCD in HD patients. This study investigated whether the heart rate-corrected QT (QTc) interval becomes prolonged along with dialysis vintage.


A total of 102 HD patients were retrospectively studied. Their ECG data were analyzed at 1, 4, and 7 years after HD initiation. The control group comprised 68 age-matched individuals who had normal renal function and two available ECG reports at an interval of more than 4 years. QTc was measured according to the Bazett formula. The association between QTc interval and dialysis vintage was studied. Additionally, clinically relevant variables related to QTc duration at 1 year after HD initiation were assessed.


Average QTc interval at 4 and 7 years after HD initiation was significantly longer than that at 1 year after HD initiation (443, 445, and 437 ms) (p<0.05). On the other hand, QTc interval in the control group was 425 ms in the first year and 426 ms after an average of 6 years. They had no significant differences, although they were much shorter than that in HD patients. Multivariate regression analysis of baseline variables revealed that the corrected calcium levels (p = 0.041) and diabetes (p = 0.043) were independently associated with longer QTc interval.


The QTc interval at 1 year after HD initiation was longer than in the control subjects and was prolonged over several years of HD treatment. Providing clinical management with a focus on QTc interval may be helpful for reducing the incidence of SCD in HD patients.

Conflict of interest statement

The authors have declared that no competing interests exist.

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