[Holter heart rhythm disorders in patients with acute kidney injury during hemodialysis]

Rev Med Inst Mex Seguro Soc. 2020 Apr 13;58(2):145-153. doi: 10.24875/RMIMSS.M20000012.
[Article in Spanish]


Background: The presence of acute renal injury has been associated with increased cardiovascular morbidity and mortality (sudden death and arrhythmias).

Objective: To know the frequency of heart rhythm disorders documented by Holter in patients in need of intermittent hemodialysis due to acute renal injury.

Material and methods: A prospective observational study was conducted including patients with a diagnosis of acute renal injury who received intermittent hemodialysis; demographic, clinical and laboratory data were collected from 28 patients. Monitoring was carried out through Holter before, during and after the hemodialysis session. Nonparametric statistics were used, with a significant value of p < 0.05. Risks were established with logistic regression.

Results: There was a significant difference in supraventricular extra systoles (82.1% vs. 57.1%), ventricular extra systoles (26.7% vs. 3.6%), and supraventricular tachycardia (6.7% vs. 3.6%). The rest of the rhythm alterations without significance.

Conclusions: Intermittent hemodialysis is a factor associated with the appearance of heart rhythm disorders. The death of patients with acute renal injury and substitution was related to ventricular extra systole detected by transhemodialysis Holter.

Introducción: La presencia de lesión renal aguda se ha asociado a unas mayores morbilidad y mortalidad de causa cardiovascular (muerte súbita y arritmias).

Objetivo: Conocer la frecuencia de trastornos del ritmo cardiaco documentado por Holter en pacientes con necesidad de hemodiálisis intermitente por lesión renal aguda.

Material y métodos: Se realizó un estudio observacional, prospectivo, en pacientes con diagnóstico de lesión renal aguda que recibieron hemodiálisis intermitente; se recabaron datos demográficos, clínicos y de laboratorio de 28 pacientes. Se realizó monitoreo mediante Holter, previo, durante y posterior a la sesión de hemodiálisis. Se utilizó estadística no paramétrica, con un valor significativo de p < 0.05. Se establecieron riesgos con regresión logística.

Resultados: Hubo diferencia significativa en extrasístoles supraventriculares (82.1% frente a 57.1%), extrasístoles ventriculares (26.7% frente a 3.6%) y taquicardia supraventricular (6.7% frente a 3.6%). El resto de las alteraciones del ritmo no mostraron significancia.

Conclusiones: La hemodiálisis intermitente es un factor asociado a la aparición de trastornos del ritmo cardiaco. La muerte de los pacientes con lesión renal aguda y sustitución estuvo relacionada con la extrasístole ventricular detectada por Holter transhemodiálisis.

Keywords: Acute Kidney Injury; Arrhythmias, Cardiac; Electrocardiography, Ambulatory; Holter; Renal Dialysis.

Publication types

  • Observational Study

MeSH terms

  • Acute Kidney Injury* / diagnosis
  • Acute Kidney Injury* / epidemiology
  • Acute Kidney Injury* / etiology
  • Arrhythmias, Cardiac / diagnosis
  • Arrhythmias, Cardiac / epidemiology
  • Arrhythmias, Cardiac / etiology
  • Electrocardiography, Ambulatory*
  • Humans
  • Prospective Studies
  • Renal Dialysis / adverse effects