Electrolyte concentration during haemodialysis and QT interval prolongation in uraemic patients
Electrolyte concentration during haemodialysis and QT interval prolongation in uraemic patients
复制标题
DOI：
10.1093/europace/eun028
复制
发表时间：
2008-06-01
期刊：
影响因子：
6.1
通讯作者：
Stramba-Badiale, Marco
中科院分区：
文献类型：
--
作者：
Genovesi, Simonetta;Dossi, Chiara;Stramba-Badiale, Marco
目的评估尿毒症患者透析浴中不同钾和钙浓度组合对QT间期的影响。方法和结果16例血液透析（HD）患者在HD前和HD期间进行了24 h霍尔特记录，透析浴中电解质浓度为6种随机组合。（K+，2和3 mmol/L; Ca 2+，1.25、1.5和1.75 mmol/L）。不同透析浴对QT间期的影响有统计学意义（P < 0.05）。在最低K+（2 mmol/L）和Ca 2+浓度（1.25 mmol/L）时观察到平均QTc最长，而在最高K+（3 mmol/L）和Ca 2+浓度（1.75 mmol/L）时观察到平均QTc最短。在最低Ca 2+和K+浓度下，16例患者中有9例（56%）的QTc> 440 ms，在最高电解质水平下，16例患者中有3例（18%）的QTc> 440 ms。血液透析过程中QTc的变化与血浆总Ca和Ca 2+浓度呈负相关（P < 0.0001）。这些发现可能对HD期间透析浴电解质浓度的选择具有重要意义。
Aims To assess the effect of different combinations of potassium and calcium concentrations on QT interval in the dialysis bath in uraemic patients.Methods and results Sixteen haemodialysis (HD) patients underwent a 24 h Holter recording before and during HD sessions with six randomized combinations of electrolytes concentrations of the dialysis bath (K+, 2 and 3 mmol/L; Ca2+, 1.25, 1.5, and 1.75 mmol/L). The effect of different dialysis baths on QT interval was significant (P < 0.05). The longest mean QTc was observed with the lowest K+ (2 mmol/L) and Ca2+ concentrations (1.25 mmol/L), whereas the shortest mean QTc was observed with the highest K+ (3 mmol/L) and Ca2+ concentrations (1.75 mmol/L). QTc was > 440 ms in 9 of 16 patients (56%) at the lowest Ca2+ and K+ concentrations, and in 3 of 16 patients (18%) at the highest electrolytes level. Changes in QTc during the HD sessions were inversely correlated with that in total Ca and Ca2+ plasma concentrations (P < 0.0001).Conclusion Changes in ventricular repolarization duration associated with HD largely depend on the concentrations of Ca2+ and K+ in the dialysis bath. These findings may have important implications for the choice of the electrolytes concentration of the dialysis bath during the HD session.