Prevalence of abnormalities in electrocardiogram conduction in dialysis patients: a comparative study

Detalhes bibliográficos
Autor(a) principal: Ajam,Firas
Data de Publicação: 2020
Outros Autores: Akoluk,Arda, Alrefaee,Anas, Campbell,Natasha, Masud,Avais, Mehandru,Sushil, Patel,Mayukumar, Asif,Arif, Carson,Michael P.
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Jornal Brasileiro de Nefrologia
Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0101-28002020000400448
Resumo: ABSTRACT Background: The electrocardiogram (ECG) can aid in identification of chronic kidney disease (CKD) patients at high risk for cardiovascular diseases. Cohort studies describe ECG abnormalities in patients on hemodialysis (HD), but we did not find data comparing ECG abnormalities among patients with normal kidney function or peritoneal dialysis (PD) to those on hemodialysis. We hypothesized that ECG conduction abnormalities would be more common, and cardiac conduction interval times longer, among patients on hemodialysis vs. those on peritoneal dialysis and CKD 1 or 2. Methods: Retrospective review of adult inpatients’ charts, comparing those with billing codes for “Hemodialysis” vs. inpatients without those charges, and an outpatient peritoneal dialysis cohort. Patients with CKD 3 or 4 were excluded. Results: One hundred and sixty-seven charts were reviewed. ECG conduction intervals were consistently and statistically longer among hemodialysis patients (n=88) vs. peritoneal dialysis (n=22) and CKD stage 1 and 2 (n=57): PR (175±35 vs 160±44 vs 157±22 msec) (p=0.009), QRS (115±32 vs. 111±31 vs 91±18 msec) (p=0.001), QT (411±71 vs. 403±46 vs 374±55 msec) (p=0.006), QTc (487±49 vs. 464±38 vs 452±52 msec) (p=0.0001). The only significantly different conduction abnormality was prevalence of left bundle branch block: 13.6% among HD patients, 5% in PD, and 2% in CKD 1 and 2 (p=0.03). Conclusion: To our knowledge, this is the first study to report that ECG conduction intervals are significantly longer as one progresses from CKD Stage 1 and 2, to PD, to HD. These and other data support the need for future research to utilize ECG conduction times to identify dialysis patients who could potentially benefit from proactive cardiac evaluations and risk reduction.
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spelling Prevalence of abnormalities in electrocardiogram conduction in dialysis patients: a comparative studyRenal Insufficiency, ChronicRenal DialysisElectrocardiographyABSTRACT Background: The electrocardiogram (ECG) can aid in identification of chronic kidney disease (CKD) patients at high risk for cardiovascular diseases. Cohort studies describe ECG abnormalities in patients on hemodialysis (HD), but we did not find data comparing ECG abnormalities among patients with normal kidney function or peritoneal dialysis (PD) to those on hemodialysis. We hypothesized that ECG conduction abnormalities would be more common, and cardiac conduction interval times longer, among patients on hemodialysis vs. those on peritoneal dialysis and CKD 1 or 2. Methods: Retrospective review of adult inpatients’ charts, comparing those with billing codes for “Hemodialysis” vs. inpatients without those charges, and an outpatient peritoneal dialysis cohort. Patients with CKD 3 or 4 were excluded. Results: One hundred and sixty-seven charts were reviewed. ECG conduction intervals were consistently and statistically longer among hemodialysis patients (n=88) vs. peritoneal dialysis (n=22) and CKD stage 1 and 2 (n=57): PR (175±35 vs 160±44 vs 157±22 msec) (p=0.009), QRS (115±32 vs. 111±31 vs 91±18 msec) (p=0.001), QT (411±71 vs. 403±46 vs 374±55 msec) (p=0.006), QTc (487±49 vs. 464±38 vs 452±52 msec) (p=0.0001). The only significantly different conduction abnormality was prevalence of left bundle branch block: 13.6% among HD patients, 5% in PD, and 2% in CKD 1 and 2 (p=0.03). Conclusion: To our knowledge, this is the first study to report that ECG conduction intervals are significantly longer as one progresses from CKD Stage 1 and 2, to PD, to HD. These and other data support the need for future research to utilize ECG conduction times to identify dialysis patients who could potentially benefit from proactive cardiac evaluations and risk reduction.Sociedade Brasileira de Nefrologia2020-12-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0101-28002020000400448Brazilian Journal of Nephrology v.42 n.4 2020reponame:Jornal Brasileiro de Nefrologiainstname:Sociedade Brasileira de Nefrologia (SBN)instacron:SBN10.1590/2175-8239-jbn-2020-0018info:eu-repo/semantics/openAccessAjam,FirasAkoluk,ArdaAlrefaee,AnasCampbell,NatashaMasud,AvaisMehandru,SushilPatel,MayukumarAsif,ArifCarson,Michael P.eng2021-01-19T00:00:00Zoai:scielo:S0101-28002020000400448Revistahttp://www.bjn.org.br/ONGhttps://old.scielo.br/oai/scielo-oai.php||jbn@sbn.org.br2175-82390101-2800opendoar:2021-01-19T00:00Jornal Brasileiro de Nefrologia - Sociedade Brasileira de Nefrologia (SBN)false
dc.title.none.fl_str_mv Prevalence of abnormalities in electrocardiogram conduction in dialysis patients: a comparative study
title Prevalence of abnormalities in electrocardiogram conduction in dialysis patients: a comparative study
spellingShingle Prevalence of abnormalities in electrocardiogram conduction in dialysis patients: a comparative study
Ajam,Firas
Renal Insufficiency, Chronic
Renal Dialysis
Electrocardiography
title_short Prevalence of abnormalities in electrocardiogram conduction in dialysis patients: a comparative study
title_full Prevalence of abnormalities in electrocardiogram conduction in dialysis patients: a comparative study
title_fullStr Prevalence of abnormalities in electrocardiogram conduction in dialysis patients: a comparative study
title_full_unstemmed Prevalence of abnormalities in electrocardiogram conduction in dialysis patients: a comparative study
title_sort Prevalence of abnormalities in electrocardiogram conduction in dialysis patients: a comparative study
author Ajam,Firas
author_facet Ajam,Firas
Akoluk,Arda
Alrefaee,Anas
Campbell,Natasha
Masud,Avais
Mehandru,Sushil
Patel,Mayukumar
Asif,Arif
Carson,Michael P.
author_role author
author2 Akoluk,Arda
Alrefaee,Anas
Campbell,Natasha
Masud,Avais
Mehandru,Sushil
Patel,Mayukumar
Asif,Arif
Carson,Michael P.
author2_role author
author
author
author
author
author
author
author
dc.contributor.author.fl_str_mv Ajam,Firas
Akoluk,Arda
Alrefaee,Anas
Campbell,Natasha
Masud,Avais
Mehandru,Sushil
Patel,Mayukumar
Asif,Arif
Carson,Michael P.
dc.subject.por.fl_str_mv Renal Insufficiency, Chronic
Renal Dialysis
Electrocardiography
topic Renal Insufficiency, Chronic
Renal Dialysis
Electrocardiography
description ABSTRACT Background: The electrocardiogram (ECG) can aid in identification of chronic kidney disease (CKD) patients at high risk for cardiovascular diseases. Cohort studies describe ECG abnormalities in patients on hemodialysis (HD), but we did not find data comparing ECG abnormalities among patients with normal kidney function or peritoneal dialysis (PD) to those on hemodialysis. We hypothesized that ECG conduction abnormalities would be more common, and cardiac conduction interval times longer, among patients on hemodialysis vs. those on peritoneal dialysis and CKD 1 or 2. Methods: Retrospective review of adult inpatients’ charts, comparing those with billing codes for “Hemodialysis” vs. inpatients without those charges, and an outpatient peritoneal dialysis cohort. Patients with CKD 3 or 4 were excluded. Results: One hundred and sixty-seven charts were reviewed. ECG conduction intervals were consistently and statistically longer among hemodialysis patients (n=88) vs. peritoneal dialysis (n=22) and CKD stage 1 and 2 (n=57): PR (175±35 vs 160±44 vs 157±22 msec) (p=0.009), QRS (115±32 vs. 111±31 vs 91±18 msec) (p=0.001), QT (411±71 vs. 403±46 vs 374±55 msec) (p=0.006), QTc (487±49 vs. 464±38 vs 452±52 msec) (p=0.0001). The only significantly different conduction abnormality was prevalence of left bundle branch block: 13.6% among HD patients, 5% in PD, and 2% in CKD 1 and 2 (p=0.03). Conclusion: To our knowledge, this is the first study to report that ECG conduction intervals are significantly longer as one progresses from CKD Stage 1 and 2, to PD, to HD. These and other data support the need for future research to utilize ECG conduction times to identify dialysis patients who could potentially benefit from proactive cardiac evaluations and risk reduction.
publishDate 2020
dc.date.none.fl_str_mv 2020-12-01
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
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dc.relation.none.fl_str_mv 10.1590/2175-8239-jbn-2020-0018
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dc.publisher.none.fl_str_mv Sociedade Brasileira de Nefrologia
publisher.none.fl_str_mv Sociedade Brasileira de Nefrologia
dc.source.none.fl_str_mv Brazilian Journal of Nephrology v.42 n.4 2020
reponame:Jornal Brasileiro de Nefrologia
instname:Sociedade Brasileira de Nefrologia (SBN)
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