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Cardiac repolarization abnormalities among patients with various stages of chronic kidney disease

Khaled A Sherif1, Elsayed Abo-Salem, Ragesh Panikkath

  • 1Department of Geriatrics, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma.

Clinical Cardiology
|July 22, 2014
PubMed

Insights

Chronic kidney disease (CKD) significantly delays cardiac repolarization, increasing arrhythmia risk. This progression is linked to worsening kidney function, independent of other factors, and may elevate sudden cardiac death risk.

Area of Science:

  • Cardiology
  • Nephrology
  • Clinical Electrophysiology

Background:

  • Patients with chronic kidney disease (CKD) face elevated risks of life-threatening cardiovascular arrhythmias.
  • While often linked to structural heart disease, some sudden cardiac deaths in CKD patients lack clear structural causes.
  • This study investigates cardiac repolarization in CKD patients with progressing kidney dysfunction.

Purpose of the Study:

  • To explore the relationship between cardiac repolarization and worsening kidney function in CKD patients.
  • To determine if cardiac repolarization abnormalities are present in CKD patients.
  • To assess the impact of CKD progression on cardiac repolarization.

Main Methods:

  • Retrospective chart review of CKD patients at a university hospital (2005-2010).
  • Inclusion criteria: 12-lead ECG, recent renal function tests, and echocardiography.
  • Exclusion of cases with known causes for corrected QT (QTc) interval prolongation.

Main Results:

  • Two-thirds of CKD patients exhibited QTc interval prolongation; 20% had QTc >500 ms.
  • QTc interval significantly increased with advanced CKD stages (P < 0.006) and correlated with serum creatinine (P = 0.01).
  • Findings were independent of age, gender, potassium, and calcium levels.

Conclusions:

  • CKD progression significantly delays cardiac repolarization, independent of other risk factors.
  • This delay may increase the risk of sudden cardiac death in CKD patients.
  • Delayed repolarization might also heighten susceptibility to drug-induced arrhythmias.
Abstract

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