Prognostic Significance of Prolonged QTc Interval in Patients on Dialysis: A Retrospective Cohort Study

Prolonged QT interval is common in end-stage renal disease (ESRD) on dialysis, but its long-term cardiovascular (CV) implications remain unclear.

Using TriNetX network (2010-2024), we identified adults with ESRD on dialysis and categorized them by QTc status. After 1:1 propensity score matching (n = 3428/group), outcomes (hazard ratio [HR]) were assessed using Cox regression.

Prolonged QTc (> 500 ms) was associated with higher risk of all-cause mortality (HR 1.67; p < 0.001), MACEs (HR 1.40; p < 0.001), cardiac arrest (HR 1.75; p < 0.001), sustained ventricular arrhythmia (HR 1.66; p < 0.001), new-onset atrial fibrillation (HR 1.12; p = 0.01), and acute myocardial infarction (HR 2.19; p < 0.001).

In ESRD patients on dialysis, prolonged QT interval was independently associated with adverse CV outcomes and mortality.