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Turk Kardiyol Dern Ars. 2019 Oct;47(7):572-580. doi: 10.5543/tkda.2019.64359.

The effect of hemodialysis adequacy on ventricular repolarization in end-stage kidney disease.

Author information

1
Department of Cardiology, Zonguldak Bülent Ecevit University Faculty of Medicine, Zonguldak, Turkey.
2
Department of Internal Diseases, Çukurova University Faculty of Medicine, Adana, Turkey.
3
Department of Cardiology, Zonguldak Atatürk State Hospital, Zonguldak, Turkey.

Abstract

OBJECTIVE:

Ventricular repolarization (VR) markers may predict ventricular arrhythmias and cardiac arrest. The aim of this study was to investigate the acute effects of a hemodialysis (HD) session and HD adequacy on VR markers in HD patients.

METHODS:

This cross-sectional study was conducted at 2 university hospitals with 83 patients and VR markers were measured before and after an HD session: QT, QTc, QT minimum, QT maximum, dispersion of QT (QTd), T-peak to T-end (Tp-e) interval, and Tp-e/QT. Kt/V measurements calculated using the second generation Daugirdas formula were used to indicate dialysis adequacy. The patients were divided into 2 groups according to the Kt/V value. Group 1 patients had a Kt/V of ≤1.6 with a standard dialysis dose, and Group 2 comprised those with a measurement of >1.6 with a high dialysis dose.

RESULTS:

There were 36 patients in Group 1 and 47 patients in Group 2. There were statistically significantly more female patients in Group 2 (p=0.016). After an HD session, heart rate increased, blood pressure decreased, and the QT, QTc, QT maximum, QTd, Tp-e interval, and Tp-e/QT were prolonged (p<0.05). The VR markers measured were similar in the 2 groups. VR markers were not significantly different in diabetic patients.

CONCLUSION:

HD may be a risk factor for cardiac arrest because of prolonged VR parameters, independent of HD adequacy. A high dialysis dose may not always be best for the heart.

PMID:
31582680
DOI:
10.5543/tkda.2019.64359
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