Archives of the Turkish Society of Cardiology
The effect of hemodialysis adequacy on ventricular repolarization in end-stage kidney disease [Turk Kardiyol Dern Ars]
Turk Kardiyol Dern Ars. 2019; 47(7): 572-580 | DOI: 10.5543/tkda.2019.64359

The effect of hemodialysis adequacy on ventricular repolarization in end-stage kidney disease

Belma Kalaycı1, Engin Onan2, Saime Paydaş2, Bülent Kaya2, Ülkü Adam2, Serkan Besli2, Süleyman Kalaycı3, Fürüzan Köktürk1
1Department of Cardiology, Zonguldak Bülent Ecevit University Faculty of Medicine, Zonguldak, Turkey
2Department of Internal Diseases, Çukurova University Faculty of Medicine, Adana, Turkey
3Department of Cardiology, Zonguldak Atatürk State Hospital, Zonguldak, Turkey


OBJECTIVE
Ventricular repolarization (VR) markers may predict ventricular arrhythmias and cardiac arrest. The aim of this study was to investigate the acute effects of a hemodialysis (HD) session and HD adequacy on VR markers in HD patients.

METHODS
This cross-sectional study was conducted at 2 university hospitals with 83 patients and VR markers were measured before and after an HD session: QT, QTc, QT minimum, QT maximum, dispersion of QT (QTd), T-peak to T-end (Tp-e) interval, and Tp-e/QT. Kt/V measurements calculated using the second generation Daugirdas formula were used to indicate dialysis adequacy. The patients were divided into 2 groups according to the Kt/V value. Group 1 patients had a Kt/V of ≤1.6 with a standard dialysis dose, and Group 2 comprised those with a measurement of >1.6 with a high dialysis dose.

RESULTS
There were 36 patients in Group 1 and 47 patients in Group 2. There were statistically significantly more female patients in Group 2 (p=0.016). After an HD session, heart rate increased, blood pressure decreased, and the QT, QTc, QT maximum, QTd, Tp-e interval, and Tp-e/QT were prolonged (p<0.05). The VR markers measured were similar in the 2 groups. VR markers were not significantly different in diabetic patients.

CONCLUSION
HD may be a risk factor for cardiac arrest because of prolonged VR parameters, independent of HD adequacy. A high dialysis dose may not always be best for the heart.

Keywords: Dialysis dose, hemodialysis; hemodialysis adequacy; Kt/V; QT interval; ventricular repolarization.

How to cite this article
Belma Kalaycı, Engin Onan, Saime Paydaş, Bülent Kaya, Ülkü Adam, Serkan Besli, Süleyman Kalaycı, Fürüzan Köktürk. The effect of hemodialysis adequacy on ventricular repolarization in end-stage kidney disease. Turk Kardiyol Dern Ars. 2019; 47(7): 572-580

Corresponding Author: Belma Kalaycı, Türkiye
© Copyright 2019 Archives of the Turkish Society of Cardiology
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