Evaluation of Cardiac Repolarization and Serum Electrolytes in Pre-Dialytic Stages of Chronic Kidney Disease
OBJECTIVE: Patients with chronic kidney disease (CKD) have increased risk for cardiac arrhythmias.
Other than comorbidities like diabetes mellitus and cardiovascular disease, factors like acidosis,
uremia and electrolyte imbalance may contribute to this risk. The aim of this study was to evaluate
electrocardiography (ECG) measurements of ventricular repolarization and search for related clinical
features like serum electrolytes that may indicate a risk for arrhythmias in patients with pre-dialytic
CKD.
MATERIAL and METHODS: The study included 107 patients with stage 3-5 CKD and 49 healthy
individuals. ECG parameters; QT, QTc, Tp-e, Tp-e/QT and Tp-e/QTc were measured on ECG recordings
from all participants. Clinical features and serum electrolyte values were recorded.
RESULTS: Mean QTc of patients were higher than healthy controls (p=0.008). We found positive
correlations with QTc measurements and serum magnesium and phosphorus levels. We demonstrated
that Tp-e, Tp-e/QT and Tp-e/QTc were negatively correlated with potassium levels (p=0.023, 0.042,
0.013). Regression for clinical features revealed no other relation for these correlations.
CONCLUSION: Measuring ECG parameters may help to identify additional risk factors for
arrhythmogenesis. We found increased QTc measurements in pre-dialytic CKD patients who were
younger than in previous studies. Tp-e, Tp-e/QT and Tp-e/QTc were negatively correlated with serum
potassium. Electrolyte imbalances like hypokalemia might unravel the susceptibility for arrhythmias
in CKD patients.
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