Retrospective analysis of cisapride-induced QT changes in end-stage renal disease patients

Background. This study involves a retrospective in-patient chart review of end-stage renal disease (ESRD) patients receiving haemodialysis to observe if cisapride significantly increases heart rate (HR), QT, and corrected QT (QTc) intervals on 12-lead electrocardiograms (ECGs). Methods. Medical records for 23 patients who were being treated with chroni c maintenance haemodialysis and had greater than or equal to2 ECGs while on cisapride and greater than or equal to2 ECGs while off cisapride were obta ined and reviewed. HR, QT, and QTc on all 12-lead ECGs, reason for admissio n, and past medical history were analysed. Results, A total of 529 ECGs (279 on/250 off cisapride) for 23 patients wer e included. The results, as calculated by each patient's individual average s (n = 23), on vs off cisapride respectively, were HR, 88+/-14 vs 84+/-17 b eats/min (P=0.18); QT, 373+/-39 vs 382+/-45 ms (P=0.24); and QTc, 443+/-27 vs 441+/-21 ms (P=0.39). No significant difference was found in the number of admissions per month while on or off cisapride. No patient had an averag e QTc on or off cisapride that was > 500 ms. One patient died from ventricu lar arrhythmia 12 days after discontinuing cisapride. The patient's QTc was significantly longer on vs off cisapride (487 vs 462, ms, P=0.007); howeve r, this patient had an extensive cardiac history and multiple syncopal epis odes prior to the use of cisapride. Conclusions. This study found no significant overall difference in HR, QT, and QTc interval or admissions/month on vs off cisapride in ESRD patients r eceiving haemodialysis.