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QT dispersion in hemodialysis and CAPD patients
G Kantarci1, C Ozener, S Tokay
1Department of Nephrology, Marmara University School of Medicine, Istanbul, Turkey. drgulcin@superonline.com
Insights
End-stage renal disease patients undergoing hemodialysis (HD) or continuous ambulatory peritoneal dialysis (CAPD) show increased QT interval dispersion, indicating a higher risk of cardiac arrhythmias compared to healthy individuals. Dialysis type did not significantly alter this risk.
Area of Science:
- Cardiology
- Nephrology
- Electrophysiology
Background:
- QT interval dispersion (QTd) is linked to sudden cardiac death and ventricular arrhythmias.
- End-stage renal disease (ESRD) patients are at increased risk for cardiac complications.
Purpose of the Study:
- To evaluate the impact of hemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD) on QT dispersion in ESRD patients.
- To compare QT dispersion between HD, CAPD, and healthy control groups.
Main Methods:
- 12-lead ECGs were recorded in 20 chronic HD patients, 20 CAPD patients, and 20 healthy volunteers.
- ECGs were analyzed manually to measure QT interval dispersion.
- Biochemical parameters including potassium, BUN, creatinine, sodium, and calcium were compared.
Main Results:
- QT interval dispersion rates were significantly higher in both HD and CAPD patients compared to healthy controls (p < 0.05).
- No significant difference in QT dispersion rates was observed between HD and CAPD patients.
- Serum potassium levels were significantly higher in HD patients than in CAPD patients.
Conclusions:
- Both HD and CAPD are associated with increased QT dispersion, suggesting a propensity for cardiac arrhythmias in ESRD patients.
- The findings highlight the need for careful cardiac monitoring in patients undergoing renal replacement therapy.
Abstract:
Prolongation of repolarization dispersion (QT interval dispersion) measured from the 12-lead surface ECG has been associated with sudden cardiac death and ventricular tachyarrhythmias in a variety of cardiac disorders. The aim of our study was to assess the effects of hemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD) on QT dispersion in end-stage renal disease patients. 20 chronic HD patients (mean age 57.75 +/- 13.79 years) and 20 CAPD patients (mean age 50.79 +/- 14.94 years) who had no complaints and symptoms of cardiac arrhythmias as well as 20 healthy volunteers (mean age 48.74 +/- 10.88 years) underwent ECG testing. All HD patients were on bicarbonate three times weekly with cuprophane capillaries. 12-lead ECGs were recorded on the day after HD. The CAPD patients were on a standard CAPD program (four times daily with 2,000 cm(3) peritoneal fluid). ECGs were recorded when the patients were receiving their regular standard CAPD program. All ECGs were analyzed manually by one observer. There were no statistically significant differences in dialysis duration, blood urea nitrogen, creatinine, sodium, calcium, and parathormone values between the HD and CAPD patients. The serum potassium values were significantly higher in HD patients when compared to CAPD patients. There was no difference in the mean of maximal QT among all three groups. The rate of QT interval dispersions was significantly higher in HD and CAPD patients as compared with healthy controls (p < 0.05). There was no statistically significant difference in the QT dispersion rates between HD and CAPD patients. In conclusion, there is a tendency to cardiac arrhythmias in HD patients during the postdialysis period. Although CAPD patients are receiving dialysis daily, they also have higher rates of QT dispersions and accordingly a tendency to arrhythmias.