Electrocardiographic changes during hemodiafiltration with different potassium removal rates

Blood Purif. 2003;21(6):381-8. doi: 10.1159/000073440.

Abstract

Background/aims: Sudden K removal is thought to be implicated in ECG alterations observed during hemodialysis (HD). The effects of the K removal rate on ECG-derived parameters have been investigated.

Methods: Two different hemodiafiltration (HDF) schedules were used for 10 HD patients: the dialysate K concentration was kept constant in HDFst, while in HDFK it was decreased during the session in order to maintain a uniform plasma-dialysate K gradient. A 12-lead Holter monitor was used to acquire the ECG in the course of the treatments. Classical ECG parameters and overall indices for quantifying ventricular repolarization abnormalities were evaluated.

Results: Several ECG parameters were affected by both HD therapies (ST depression, QRS amplitude and QT dispersion), but only indices of the homogeneity of repolarization (PCA-T, E1-T) were significantly affected by the K removal rate.

Conclusion: The present study confirms the large impact of HD therapy on ECG. The analysis of the spatial T wave complexity points out the intrinsic arrhythmogenic implications of the K removal rate.

Publication types

  • Clinical Trial
  • Comparative Study
  • Controlled Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Arrhythmias, Cardiac / etiology
  • Calcium / blood
  • Electrocardiography*
  • Female
  • Heart Conduction System / physiopathology
  • Hemodiafiltration / adverse effects*
  • Hemodiafiltration / methods
  • Hemodynamics
  • Humans
  • Kinetics
  • Male
  • Middle Aged
  • Potassium / blood*
  • Regression Analysis
  • Ventricular Function

Substances

  • Potassium
  • Calcium