Europace Advance Access published online on February 19, 2008
Europace, doi:10.1093/europace/eun028
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Electrolyte concentration during haemodialysis and QT interval prolongation in uraemic patients
1 Dipartimento di Medicina Clinica e Prevenzione, Università degli Studi Milano-Bicocca, Via Cadore 48, 20052-Monza, Italy; 2 Clinica Nefrologica Ospedale, S. Gerardo Monza, Italy; 3 IRCCS Istituto Auxologico Italiano, Milano, Italy
Aims: To assess the effect of different combinations of potassium and calcium concentrations on QT interval in the dialysis bath in uraemic patients.
Methods and results: Sixteen haemodialysis (HD) patients underwent a 24 h Holter recording before and during HD sessions with six randomized combinations of electrolytes concentrations of the dialysis bath (K+, 2 and 3 mmol/L; Ca2+, 1.25, 1.5, and 1.75 mmol/L). The effect of different dialysis baths on QT interval was significant (P < 0.05). The longest mean QTc was observed with the lowest K+ (2 mmol/L) and Ca2+ concentrations (1.25 mmol/L), whereas the shortest mean QTc was observed with the highest K+ (3 mmol/L) and Ca2+ concentrations (1.75 mmol/L). QTc was >440 ms in 9 of 16 patients (56%) at the lowest Ca2+ and K+ concentrations, and in 3 of 16 patients (18%) at the highest electrolytes level. Changes in QTc during the HD sessions were inversely correlated with that in total Ca and Ca2+ plasma concentrations (P < 0.0001).
Conclusion: Changes in ventricular repolarization duration associated with HD largely depend on the concentrations of Ca2+ and K+ in the dialysis bath. These findings may have important implications for the choice of the electrolytes concentration of the dialysis bath during the HD session.
Key Words: QT interval, Haemodialysis, Potassium, Calcium
* Corresponding author. Tel: +39 039 2332375; fax: +39 039 2332376. E-mail address: simonetta.genovesi{at}unimib.it
Manuscript submitted 19 September 2007. Accepted after revision 19 January 2008.
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  F. A. Gotch Pro/Con debate: the calculation on calcium balance in dialysis lowers the dialysate calcium concentrations (pro part) Nephrol. Dial. Transplant., October 1, 2009; 24(10): 2994 - 2996. [Full Text] [PDF]
|
|
|
|
|
|
S. Genovesi, M. G. Valsecchi, E. Rossi, D. Pogliani, I. Acquistapace, V. De Cristofaro, A. Stella, and A. Vincenti Sudden death and associated factors in a historical cohort of chronic haemodialysis patients Nephrol. Dial. Transplant., August 1, 2009; 24(8): 2529 - 2536. [Abstract] [Full Text] [PDF]
|
|