Influence of computer-modulated profile haemodialysis on cardiac arrhythmias.
To reduce hamodialysis-induced ventricular arrhythmias, each of 15 patients (age 66.9 +/- 6.2 years) with end-stage renal disease and cardiac irregularities was treated subsequently with four different computer-modulated bicarbonate haemodialysis profiles (A-D) for 2 weeks respectively: (A) constant UF, dialysate Na (138 mmol/l) and K (2 mmol/l); (B) decreasing UF, otherwise as (A); (C) decreasing UF and Na (starting with 10% higher than serum Na), otherwise as (A); (D) decreasing UF and Na, adapted K to achieve a maximal reduction of serum K of only 15%/h. Cardiac monitoring was done by 11 h ECG. Only in haemodialysis profile D a distinct reduction of ventricular extrasystoles during and after haemodialysis was obtained. It was accompanied by an improvement in the Lown classification. In addition, a weak but highly predictive correlation between the number of ventricular extrasystoles in the last hour of dialysis and the difference between pre- and post-dialysis potassium concentration in the serum could be established (r = 0.37; P less than 0.004). Computer-modulated potassium profile haemodialysis is a useful tool to reduce the number and severity of ventricular extrasystoles.
Ebel
H
H
Department of Nephrology, University of Marburg, FRG.
Saure
B
B
Laage
C
C
Dittmar
A
A
Keuchel
M
M
Stellwaag
M
M
Lange
H
H
D000368:Aged; D001145:Arrhythmias, Cardiac / Q000209:etiology / Q000517:prevention & control*; D005117:Cardiac Complexes, Premature / Q000209:etiology / Q000517:prevention & control; D003201:Computers; D015314:Dialysis Solutions; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011188:Potassium / Q000097:blood; D006435:Renal Dialysis / Q000009:adverse effects / Q000379:methods*
D015314:Dialysis Solutions; D011188:Potassium