Turk Kardiyol Dern Ars. Ahead of Print: TKDA-64359 | DOI: 10.5543/tkda.2019.64359
The effect of hemodialysis adequacy on ventricularrepolarization in end-stage kidney disease
, Engin Onan2
, Saime Paydaş2
, Bülent Kaya2
, Ülkü Adam2
, Serkan Besli2
, Süleyman Kalaycı3
, Fürüzan Köktürk11
Department of Cardiology, Zonguldak Bülent Ecevit University Faculty of Medicine, Zonguldak, Turkey2
Department of Internal Diseases, Çukurova University Faculty of Medicine, Adana, Turkey3
Department of Cardiology, Zonguldak Atatürk State Hospital, Zonguldak, Turkey
OBJECTIVE Ventricular repolarization markers may predict ventricular arrhythmias and cardiac arrest. This study aimed to investigate the acute effects of a hemodialysis session and hemodialysis adequacy on ventricular repolarization markers in hemodialysis patients.
METHODS The cross-sectional study conducted in two university hospitals and we measured ventricular repolarization markers before and after a hemodialysis session, including QT, QTc, QT minimum, QT maximum, dispersion of QT (QTd), Tp-e interval and Tp-e/QT in 83 hemodialysis patients. Kt/V reflected dialysis adequacy that was calculated using the second generation Daugirdas formula. Patients were divided into two groups according to the Kt/V value, group 1 ≤1.6 as standard dialysis dose and group 2 >1.6 as high dialysis dose.
RESULTS 36 patients were in group 1 and 47 patients were in group 2. There were statistically significantly more female patients in the group 2 (p=0.016). After hemodialysis heart rate increased, blood pressure decreased, QT, QTc, QT maximum, QTd, Tpe interval and Tpe/QT prolonged after hemodialysis session (p<0.05). Ventricular repolarization markers were found similar in two groups. In diabetic patients ventricular repolarization markers also did not affected with Kt/V values.
CONCLUSION Hemodialysis session may be a risk factor for cardiac arrest in hemodialysis patients because of prolonged ventricular repolarization parameters independently hemodialysis adequacy. High dialysis dose may not always be the best for the heart.
Dialysis dose, hemodialysis; hemodialysis adequacy; Kt/V; QT interval; ventricular repolarization.
How to cite this article
Corresponding Author: Belma Kalaycı, Türkiye