Electrocardiographic changes during hemodiafiltration with different potassium removal rates.
OBJECTIVE
Sudden K removal is thought to be implicated in ECG alterations observed during hemodialysis (HD). The effects of the K removal rate on ECG-derived parameters have been investigated.


METHODS
Two different hemodiafiltration (HDF) schedules were used for 10 HD patients: the dialysate K concentration was kept constant in HDFst, while in HDFK it was decreased during the session in order to maintain a uniform plasma-dialysate K gradient. A 12-lead Holter monitor was used to acquire the ECG in the course of the treatments. Classical ECG parameters and overall indices for quantifying ventricular repolarization abnormalities were evaluated.


RESULTS
Several ECG parameters were affected by both HD therapies (ST depression, QRS amplitude and QT dispersion), but only indices of the homogeneity of repolarization (PCA-T, E1-T) were significantly affected by the K removal rate.


CONCLUSIONS
The present study confirms the large impact of HD therapy on ECG. The analysis of the spatial T wave complexity points out the intrinsic arrhythmogenic implications of the K removal rate.
Severi
Stefano
S
Biomedical Engineering Laboratory, DEIS, University of Bologna, Bologna, Cesena, Italy. sseveri@deis.unibo.it
Vecchietti
Stefania
S
Cavalcanti
Silvio
S
Mancini
Elena
E
Santoro
Antonio
A
D000368:Aged; D000369:Aged, 80 and over; D001145:Arrhythmias, Cardiac / Q000209:etiology; D002118:Calcium / Q000097:blood; D004562:Electrocardiography; D005260:Female; D006329:Heart Conduction System / Q000503:physiopathology; D017583:Hemodiafiltration / Q000009:adverse effects* / Q000379:methods; D006439:Hemodynamics; D006801:Humans; D007700:Kinetics; D008297:Male; D008875:Middle Aged; D011188:Potassium / Q000097:blood*; D012044:Regression Analysis; D016276:Ventricular Function
D011188:Potassium; D002118:Calcium