Electrocardiographic abnormalities in patients receiving hemodialysis

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A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis

Published on: December 28, 2012

S Abe1, M Yoshizawa, N Nakanishi

  • 1Department of Internal Medicine, Keio University, Tokyo, Japan.

American Heart Journal
|June 1, 1996
PubMed

Insights

Maintenance hemodialysis patients frequently exhibit electrocardiographic (ECG) abnormalities, particularly those who are male, elderly, hypertensive, or diabetic. These ECG changes, including arrhythmias and ST-T alterations, often occur in relation to hemodialysis timing.

Area of Science:

  • Cardiology
  • Nephrology

Background:

  • Maintenance hemodialysis (HD) is a vital treatment for end-stage renal disease.
  • Electrocardiographic (ECG) abnormalities are common in patients undergoing HD, but their specific patterns and associations require detailed assessment.

Purpose of the Study:

  • To evaluate the prevalence and characteristics of standard 12-lead and Holter ECG abnormalities in patients receiving maintenance hemodialysis.
  • To identify patient-specific factors associated with ECG changes and to explore the temporal relationship between ECG findings and HD sessions.

Main Methods:

  • A cross-sectional study involving 221 outpatients undergoing maintenance hemodialysis.
  • Analysis of standard 12-lead ECGs and 24-hour Holter monitoring recordings.
  • Comparison of serial ECGs in a subset of patients to assess changes over time.

Main Results:

  • 65% of HD patients presented with ECG abnormalities, with higher rates in males, the elderly, hypertensive, and diabetic individuals.
  • ECG changes correlated inversely with HD duration; serial ECGs revealed stable abnormalities in 31% and worsening in 25% of patients.
  • Holter monitoring identified a high incidence of arrhythmias (supraventricular and ventricular premature contractions) and ST-T changes (60%), with 40% of ventricular arrhythmias occurring during or shortly after HD.

Conclusions:

  • Patients on maintenance hemodialysis exhibit a wide spectrum of ECG abnormalities.
  • Holter ECGs are crucial for detecting frequent arrhythmias and ST-T changes, often linked temporally to hemodialysis.
  • Age, hypertension, and diabetes are significant risk factors for abnormal ECG findings in this population.

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