The Comparison of Four Different Dialysates on QT Dispersion and Arrhythmias in Hemodialysis Patients

OBJECTIVES: Sudden cardiac death (SCD) is common in patients with end-stage renal disease receiving hemodialysis. SCD may be caused by electrolyte imbalance or malignant arrhythmias in hemodialysis patients. We aimed to evaluate the effects of four different dialysates on QT dispersion and arrhythmia.

MATERIAL and METHODS: Twenty-one patients receiving hemodialysis were enrolled. Four different dialysates were used and twelve-lead ECG measurements were recorded to determine QTc and QTc dispersion. Holter ECG was performed to assess arrhythmia.

RESULTS: In group 1 (1.0 K +, 1.5 Ca++), predialytic and postdialytic QTc dispersion measurements were 52.3±11.7 and 59.2± 13.1 msec respectively and this is statistically significant (p=0.007). In group 2 (2.0 K +, 1.5 Ca++), group 3 (1.0K +, 1.75Ca++), and in group 4 (2.0 K +, 1.75Ca++), QTc dispersion measurements were 53.5±14.4 and 53.2± 15.0 msec, 53.5±14.4 and 53.2±15.0 msec, 50.8±12.0 and 52.2±13.3 msec, 51.3±12.2 and 52.1±12.3 msec, respectively, and these were not statistically significant.

CONCLUSION: In group 1, patients had higher QTc dispersion. There was no statistically significant difference regarding QTc dispersion among the four groups. We also could not find an increased rate of arrhythmias in the groups. These results suggest that there may be other causative risk factors that can affect QT dispersion and arrhythmias in hemodialysis patients.