Factors inducing increase of QT-interval dispersion in patients on program hemodialysis or continuous ambulatory peritoneal dialysis


A.S. Korelina, T.V. Zhdanova, A.V. Nazarov

1 Propaedeutics of Internal Diseases Department at State Budgetary Institution of High Professional Education “ Ural State Medical Academy”, Ekaterinburg
Purpose. Parameters to determine the relationship of the QT interval with laboratory factors and structural and functional performance of the heart in patients with terminal chronic renal failure (ESRD).Material and methods. The study included 22 patients who were on maintenance hemodialysis (HD), 21 patients - on continuous ambulatory peritoneal dialysis (CAPD), 20 patients - with a conservative-stage renal disease. All patients were performed laboratory tests, echocardiography (echocardiography) and 12-lead ECG; specifically assessed the duration and dispersion of the interval QT.Results. In patients treated with HD, the parameters of the QT interval was significantly correlated with Kt / V (r = -0,60; p <0,01), the rate of blood flow in AVF (r = -0,47; p <0,05), hemoglobin (r = -0,43; p <0,05), albumin (r = -0,42, p <0,05), urea (r = 0,48; p <0,05), ionized calcium ( r = -0,49; p <0,05), phosphorus (r = 0,54; p <0,05), potassium (r = -0,42; p <0,05), pH (r = - 0,64; p <0,05), the blood bicarbonate (r = -0,63; p <0,05), BE (r = -0,64; p <0,05). There was a significant correlation with indicators of echocardiography: aortic diameter (r = 0,44; p <0,05), left atrium (LA) (r = 0,49; p <0,05), ejection fraction (EF) ( r = -0,43; p <0,05), end-systolic dimension (DAC) (r = 0,42; p <0,05), a thickness of the rear wall of the left ventricle (TZSLZH) in diastole (r = 0,50 ; p <0,05), TZSLZH systole (r = 0,47; p <0,05), left ventricular mass (LVM) (r = 0,48; p <0,05).In patients receiving CAPD parameters of QT significantly correlated with systolic blood pressure (r = 0,50; p <0,05), albumin (r = -0,52; p <0,05), creatinine (r = 0 48; p <0,05), ionized calcium (r = -0,47 CAPD group; p <0,05), phosphorus (r = 0,46 CAPD group; p <0,05), potassium ( r = -0,60; p <0,01), the blood bicarbonate (r = -0,43; p <0,05), BE (r = -0,47; p <0,05). There was a significant correlation between the parameter QT and rates echocardiography: aortic diameter (r = 0,56; p <0,05), a flow rate of E (r = -0,48; p <0,05), a flow rate A (r = -0,46; p <0,05), of impact (EO) (r = -0,51; p <0,05), with TZSLZH systole (r = 0,48; p <0,05) and end systolic volume (CSR) (r = 0,43; p <0,05).Conclusion. Maintaining adequate mode of dialysis, prevention of anemia, hypoalbuminemia, electrolyte imbalance, acidosis, left ventricular hypertrophy will reduce the risk of sudden cardiac death in patients with ESRD.

About the Autors


Korelina A.S. – Propaedeutics of Internal Diseases Department at State Budgetary Institution of High Professional Education “ Ural State Medical Academy”, Ekaterinburg
E-mail: aistomina_85@mail.ru;
Zhdanova T.V. – professor, Propaedeutics of Internal Diseases Department at State Budgetary Institution of High Professional Education “ Ural State Medical Academy”, Ekaterinburg, Ph.D.
Nazarov A.V. – professor, head of Kidney Diseases and Dialysis Center at State Clinical Hospital # 40, Ph.D.


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