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J Renal Inj Prev. 2016 Apr 06;5(3):153-6. doi: 10.15171/jrip.2016.32. eCollection 2016.

The effects of different electrolyte composition in dialysate on QTc interval; a controlled trial.

Journal of renal injury prevention

Foroogh Sabzghabaei, Seyed Alireza Heydariezade, Rashin S Joodat

Affiliations

  1. Department of Medicine, Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran.

PMID: 27689113 PMCID: PMC5040003 DOI: 10.15171/jrip.2016.32

Abstract

INTRODUCTION: Hemodialysis (HD) has impact on the cardiovascular system by inducing changes in the characteristics of body fluids such as PH, temperature and electrolyte concentrations. In the previous studies, prolongation of the QT interval and increase of QT dispersion have been reported during HD sessions. These changes were more significant while using solutions with less potassium and higher bicarbonate during dialysis.

OBJECTIVES: The aim of our study was to investigate the effects of different potassium and bicarbonate concentrations on electrocardiography (ECG) parameters and the electrochemical balance of cell membranes.

PATIENTS AND METHODS: This is a double blind controlled clinical trial with crossover design. This interventional study has been conducted on 36 patients over 18 years who undergoing HD 3 times a week for at least 6 months. Twelve-lead ECG has been obtained before starting and one hour after end of each HD session. The QTc was measured and changes recorded by a cardiologist. Correlations were evaluated by univariate regression analysis.

RESULTS: 54.38 years (16 to 77 years), 66.7% were male. No significant increase in QT interval has been seen while dialyzing with 2 meq/l potassium and 24 meq/l bicarbonate, 2 meq/l potassium and 28 meq/l bicarbonate and 3 meq/l potassium and 24 meq/l bicarbonate beside high calcium (2.5 meq/l) dialysate was conducted. Age, gender, serum calcium and serum bicarbonate level before HD session did not influence the mean QT intervals before and after dialysis.

CONCLUSION: Concentration of potassium beside moderate dose of bicarbonate in dialysis bath had not any significant influence on QT intervals after dialysis.

Keywords: Cardiovascular disease; Dialysate fluid; Hemodialysis; QT interval

References

  1. J Nephrol. 2012 Sep-Oct;25(5):653-60 - PubMed
  2. Am J Kidney Dis. 2002 Apr;39(4):834-42 - PubMed
  3. Postgrad Med J. 2002 May;78(919):273-5 - PubMed
  4. Nephrol Dial Transplant. 2002 Dec;17(12):2170-7 - PubMed
  5. Am J Kidney Dis. 1998 Nov;32(5 Suppl 3):S112-9 - PubMed
  6. Caspian J Intern Med. 2013 Winter;4(1):590-4 - PubMed
  7. Nephron. 1998;78(4):429-32 - PubMed
  8. Am Heart J. 1996 Jun;131(6):1137-44 - PubMed
  9. Nephrol Dial Transplant. 1998 Mar;13(3):668-73 - PubMed
  10. J Hypertens. 2003 Oct;21(10):1921-6 - PubMed
  11. Clin Auton Res. 2004 Aug;14 (4):233-9 - PubMed
  12. Kidney Int. 2001 Jul;60(1):350-7 - PubMed
  13. Clin Nephrol. 1998 Apr;49(4):240-4 - PubMed
  14. Europace. 2008 Jun;10(6):771-7 - PubMed
  15. Kidney Int. 2000 May;57(5):2117-22 - PubMed
  16. J Am Soc Nephrol. 1999 Jan;10(1):160-3 - PubMed
  17. Lancet. 1992 Jan 25;339(8787):212-3 - PubMed
  18. J Am Soc Nephrol. 1999 Jun;10(6):1297-302 - PubMed
  19. Nephrol Dial Transplant. 2005 Jun;20(6):1148-54 - PubMed
  20. Nephrol Dial Transplant. 2000 Jun;15(6):765-8 - PubMed
  21. Nephrol Dial Transplant. 1992;7(4):318-22 - PubMed
  22. Physiol Rev. 2007 Apr;87(2):457-506 - PubMed

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