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Impact of hemodialysis on QT interval
1Karadeniz Technical University, Department of Internal Medicine Medical School, Trabzon, Turkey.
Insights
Hemodialysis alters serum electrolytes, affecting cardiac repolarization. This study found hemodialysis shortens the corrected QT interval (Q-oTc) and prolongs the corrected QT interval (Q-eTc) in chronic renal failure patients.
Area of Science:
- Nephrology
- Cardiology
- Clinical Electrophysiology
Background:
- Chronic renal failure (CRF) patients often have electrolyte imbalances.
- Hemodialysis is a common treatment for CRF that can alter serum calcium and potassium levels.
- These electrolyte shifts may impact cardiac repolarization, specifically the QT interval.
Purpose of the Study:
- To evaluate the effects of changes in serum calcium and potassium during hemodialysis on the QT interval.
- To assess the impact of hemodialysis on corrected QT (Q-oTc and Q-eTc) intervals in CRF patients.
Main Methods:
- 24-hour Holter electrocardiographic recordings were obtained in 20 CRF patients undergoing chronic hemodialysis.
- Serum calcium and potassium levels were measured before and during hemodialysis.
- QT intervals were analyzed and corrected for heart rate (Q-oTc and Q-eTc).
Main Results:
- Hemodialysis increased serum calcium (9.1 to 11.5 mg/dl) and decreased serum potassium (5.6 to 4.9 mEg/L).
- The Q-oTc interval shortened significantly (0.240 to 0.216 sec).
- The Q-eTc interval prolonged significantly (0.391 to 0.412 sec).
- Q-oTc shortening correlated with increased serum calcium.
- Q-eTc prolongation correlated with decreased serum potassium.
Conclusions:
- Hemodialysis induces significant changes in serum calcium and potassium levels in CRF patients.
- These electrolyte shifts during hemodialysis are associated with distinct alterations in cardiac repolarization, specifically shortening of Q-oTc and prolongation of Q-eTc intervals.
- The findings highlight the electrophysiological impact of hemodialysis on cardiac function in CRF, emphasizing the need for careful monitoring.
Abstract:
Holter electrocardiographic recordings were performed for 24 hours in 20 patients with chronic renal failure on chronic hemodialysis to evaluate the effects of changes in serum calcium and potassium during hemodialysis period on the QT interval. Hemodialysis caused an increase in serum calcium from a predialysis value of 9.1 +/- 1.3 mg/dl to 11.5 +/- 1.2 mg/dl and a decrease in serum potassium from 5.6 +/- 1.4 mEg/L to 4.9 +/- 1.2 mEg/L. The Q-oTC interval shortened from a predialysis value of 0.240 +/- 0.0023 sec to 0.216 +/- 0.024 sec during the 5th hour of hemodialysis. The Q-eTc interval increased from a predialyse value of 0.391 +/- 0.030 sec to 0.412 +/- 0.024 sec during the 5th hour of hemodialysis. This shortening of Q-oTc interval was correlated with an increase in serum calcium and Q-eTc interval prolongation was correlated with a decrease in serum potassium. It was concluded that hemodialysis caused a lengthening of the Q-eTc interval and a shortening of the Q-oTc interval.