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Hemodiyaliz Hastalarında Dört Farklı Diyalizat Kullanımının QT Dispersiyonu ve Aritmiler Üzerine Etkisi

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

Journal Name:

  • Türk Nefroloji, Diyaliz ve Transplantasyon Dergisi

Publication Year:

  • 2012
DOI: 
DOI 10.5262/tndt.2012.1002.12

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
OBJECTIVE S: 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. MATER IAL 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. RE SUL TS: 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. CONCLU SION: 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.
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Abstract (Original Language): 
AMAÇ: Ani kardiyak ölüm (AKÖ) hemodiyaliz hastalarında sık görülen bir durumdur. Günümüzde AKÖ nedenleri genellikle elektrolit imbalansına ve malign aritmilere ikincil olarak gelişmektedir. Bu nedenle çalışmamızda dört farklı eletrolit içeriğine sahip diyalizatın, QTc dispersiyonu ve intradiyalitik aritmi üzerine etkisini araştırmayı amaçladık. GERE Ç ve YÖNTEMLER : Çalışmamızda 21 hemodiyaliz hastasında bir hafta arayla dört farklı diyalizat kullanılarak diyaliz öncesi ve sonrasında 12 derivasyonlu EKG çekilerek ve intradiyalitik Holter EKG kaydedilmek suretiyle QTc dispersiyonu ve aritmi gelişimi değerlendirildi. SONUÇLAR: Hastalar kullanılan diyalizatın elektrolit içeriğine göre 4 farklı gruba ayrıldılar. Grup 1’de (mM/L olarak 1,0 K+, 1,5 Ca++) prediyalitik ve postdialitik QTc ölçümleri sırasıyla 52,3±11.7 and 59,2± 13,1 msn saptandı (p=0,007). Grup 2 (2,0 K+, 1,5 Ca++), grup 3 1,0 K+, 1,75 Ca++) ve grup 4 (2,0 K+, 1,75 Ca++), QTc ölçümleri sırasıyla 53,5±14,4 ve 53,2±15,0 msn, 53,5±14,4 ve 53,2± 15,0 msn, 50,8±12.,0 ve 52,2± 13.3 msn, 51,3±12,2 ve 52,1± 12,3 msn olarak tespit edildi. TARTIŞMA: Düşük potasyum ve kalsiyum içeriğine sahip diyalizatla hemodiyalize alınan grup 1’de diyaliz sonrası QTc dispersiyonu daha yüksek bulundu. 4 grup arasında QTc dispersiyonu açısından fark yoktu. Supraventriküler ve ventriküler aritmi riski artışı tespit edilmedi. Bu sonuçlar bize hemodiyaliz hastalarında QTc dispersiyonu ve intradiyalitik aritmi üzerine sadece diyalizat elektrolit içeriğinin değil, başka faktörlerin de etkili olabileceğini düşündürmektedir
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173-177
  • Turkish

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