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Effect of cisapride on rate-corrected QT intervals in children on peritoneal dialysis
Manfred Marx1, Erwin Kitzmueller, Andrea Pichler
1Universitaetsklinik fuer Kinder- und Jugendheilkunde Wien, AKH Wien, Waehringer Guertel 18-20, 1090 Vienna, Austria.
Insights
Cisapride may slightly prolong corrected QT (QTc) intervals in children undergoing peritoneal dialysis. Concomitant medications often contribute to these changes, highlighting the need for careful monitoring.
Area of Science:
- Pediatric Cardiology
- Nephrology
- Clinical Pharmacology
Background:
- Children on chronic peritoneal dialysis (PD) may require gastrointestinal motility agents.
- Assessing the cardiac safety of medications in pediatric PD patients is crucial.
- Corrected QT (QTc) interval prolongation is a potential risk associated with certain drugs.
Purpose of the Study:
- To evaluate the effect of cisapride on QTc intervals in children receiving peritoneal dialysis.
- To determine if cisapride significantly increases QTc intervals in this specific pediatric population.
Main Methods:
- Retrospective review of medical records and electrocardiograms (ECGs) from children on PD.
- Analysis of 12-lead ECGs performed both off and on cisapride treatment.
- Blinded assessment of QTc intervals and medical history by pediatric cardiologists.
Main Results:
- Eleven children on PD with 79 ECGs (68 off, 11 on cisapride) were analyzed.
- A mild but statistically significant increase in mean QTc intervals was observed with cisapride (394 ms vs. 414 ms, P=0.041).
- Five children showed QTc prolongation, with concomitant medications identified as contributing factors in four.
Conclusions:
- Cisapride use is associated with mild QTc interval prolongation in children on peritoneal dialysis.
- Concomitant medications appear to be significant contributors to QTc changes.
- No arrhythmias or conduction defects were noted, but careful monitoring is warranted.
Abstract:
The aim of this study was to investigate whether cisapride significantly increases corrected QT (QTc) intervals on resting 12-lead electrocardiograms (ECGs) in children on peritoneal dialysis. Medical records of children who were treated with chronic peritoneal dialysis and who had ECGs while off and on cisapride were obtained and reviewed. QTc on all 12-lead ECGs and past medical history were analyzed by two blinded pediatric cardiologists. A total of 79 ECGs (68 off/11 on cisapride) for 11 children on peritoneal dialysis were included. Of 11 children, 5 developed a prolongation of QTc, 2 of them beyond the normal range (453 and 478 ms). Mean data of QTc off versus on cisapride were 394+/-24 ms and 414+/-36 ms, respectively ( P=0.041). In 4 of the 5 children concomitant medications could be identified as factors to explain prolongation of the QT interval. No child had evidence of any arrhythmia or conduction defect on ECG. This retrospective study found mild but significant increases in QTc intervals with cisapride in children on chronic peritoneal dialysis, mostly due to concomitant medications.