M. Kayatas et al., ACETATE HEMODIALYSIS DOES NOT INCREASE THE FREQUENCY OF ARRHYTHMIA INHEMODIALYSIS-PATIENTS, Artificial organs, 22(9), 1998, pp. 781-784
Arrhythmia is one of the most important causes of mortality in patient
s on hemodialysis and may develop due to cardiovascular diseases or fl
uid-electrolyte or acid-base abnormalities. Previous studies have show
n that acetate hemodialysis (AHD) increased the frequency of arrythmia
. To evaluate the frequency and the causes of arrhythmias during AHD,
we studied 33 randomly selected patients (25 male and 8 female, mean a
ge of 45 +/- 18 years) who were under AHD (4 h, 3 times/week, mean dur
ation of HD of 38 +/- 29 months) with the same Cuprophan membranes. Al
l patients underwent a detailed echocardiographic evaluation during th
e interdialytic period. Twenty-four hours of Holter monitoring was per
formed starting from the onset of HD. Twelve lead electrocardiography
(ECG) was obtained, and venous and arterial blood samples were drawn f
or serum electrolytes, pH, and arterial blood gas measurements before
and after HD. Serum magnesium and potassium levels dropped after AHD (
from 2.3 +/- 0.5 to 1.9 +/- 0.3 mEq/L and from 5 +/- 0.7 to 3.4 +/- 0.
4 mEq/L respectively, p < 0.001); on the other hand serum pH, bicarbon
ate, sodium, and calcium levels were normalized. Electrocardiographic
evaluation revealed significant lengthening of the QTc interval (from
433 +/- 42 to 464 +/- 43 ms, p < 0.001), which was thought to be relat
ed to the decrease in serum magnesium and potassium levels. The freque
ncies of ventricular premature contractions (VPCs) were not different
during AHD and the interdialytic period (8 +/- 9.1 to 6.5 +/- 11 contr
actions/h, p > 0.05). This was also true for supraventricular prematur
e contractions (SVPCs) and supraventricular tachycardia (SVT). Nonsust
ained ventricular tachycardia was observed in 2 patients during HD and
in 1 patient in the interdialytic period. No relation was established
between the echocardiographic findings and the frequency of arrhythmi
a. In our ambulatory electrocardiographic study, the frequencies of VP
Cs and SVPCs observed during the interdialytic period were only positi
vely correlated with age (r = 0.54, p = 0.013 and r = 0.50, p = 0.010,
respectively). No relation was found between the frequency of arrhyth
mia and the gender of the patients; duration of HD; etiology of kidney
disease; or serum Na, K, Ca, iCa, Mg, bicarbonate, or pH levels (p >
0.05). In conclusion, the application of AHD does not increase the fre
quency of arrhythmia in HD patients as had been shown in previous stud
ies.