Associations of ECG interval prolongations with mortality among ESRD patients evaluated for renal transplantation

It is unknown whether prolongation of electrocardiogram (ECG) intervals is associated with mortality in end-stage renal disease (ESRD) patients evaluated for renal transplantation.

We examined the relationship between 12-lead ECG interval measurements (PR >200 ms, QRS >110 ms, or QTC >450 ms) and the presence of none, 1, and 2 or more ECG interval prolongations with all-cause mortality in 930 adult ESRD patients evaluated for renal transplantation from August 2006 to October 2008 and followed through November 2010.

A total of 108 (11.6%) patients died after a median follow-up of 3.1 years. A stepwise increase in all-cause mortality occurred among adult ESRD patients with prolongation of 1, and 2 or more ECG intervals. In adjusted analyses, the rate of death in patients with at least 1 ECG interval prolongation was 69% higher than that of patients with no ECG prolongations (HR=1.69; 95% CI: 1.05-2.73). Patients with 2 or more ECG interval prolongations had a 2.5-fold increased likelihood of dying vs. patients with no ECG interval prolongations (HR 2.53, 95% CI 1.38-4.82).

ECG interval prolongations are associated with higher mortality in patients evaluated for renal transplantation. The ECG is a potentially important evaluative tool for risk assessment in this population.