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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.

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



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.


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.


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.


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.

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