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Effect of On-Line Hemodiafiltration on P-Wave Dispersion in Children

Happy Sawires1, Samuel Makar1, Hanan Zekry1

  • 1Department of Pediatrics, Cairo University, Cairo, Egypt.

Therapeutic Apheresis and Dialysis : Official Peer-Reviewed Journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy
|March 27, 2015
PubMed

Insights

Switching pediatric patients from hemodialysis (HD) to online hemodiafiltration (OL-HDF) significantly reduced P-wave dispersion (PWD), a predictor of atrial fibrillation (AF). This suggests OL-HDF may lower AF risk in children undergoing renal replacement therapy.

Area of Science:

  • Cardiology
  • Nephrology
  • Pediatrics

Background:

  • P-wave dispersion (PWD) is a predictor of paroxysmal atrial fibrillation (AF).
  • The impact of hemodialysis (HD) on PWD and AF risk is not fully understood.
  • Online hemodiafiltration (OL-HDF) is a renal replacement therapy.

Purpose of the Study:

  • To investigate the effect of switching from conventional HD to OL-HDF on PWD in pediatric patients.
  • To assess whether OL-HDF influences the risk of developing AF in this population.

Main Methods:

  • Thirty-three pediatric patients on HD were switched to OL-HDF for 6 months.
  • Echocardiography, 12-lead ECG, and PWD were measured before and after the switch.
  • A control group of 30 healthy children was included for comparison.

Main Results:

  • PWD significantly decreased after switching to OL-HDF (P < 0.001).
  • Fractional shortening also significantly improved (P < 0.001).
  • PWD in OL-HDF patients was still higher than in healthy controls, but significantly reduced from baseline.

Conclusions:

  • OL-HDF significantly reduces PWD in pediatric patients compared to conventional HD.
  • This reduction in PWD suggests a decreased potential for AF development.
  • OL-HDF may be a preferred renal replacement modality for pediatric patients due to its potential cardiovascular benefits.

Keywords:
Atrial fibrillationDiastolic dysfunctionEnd-stage renal diseaseOnline hemodiafiltrationP-wave dispersion

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