Electrocardiographic abnormalities in patients receiving hemodialysis
S Abe1, M Yoshizawa, N Nakanishi
1Department of Internal Medicine, Keio University, Tokyo, Japan.
American Heart Journal
|June 1, 1996
Summary
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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