Determinants of augmentation of ECG QRS complexes and R waves in patients after hemodialysis.
BACKGROUND
Hemodialysis (HD) leads to an augmentation in the amplitude of QRS complexes (QRS-c), and R waves (R-w); some correlates of this phenomenon have been identified, but the exact mechanism for these ECG changes remains elusive. The objective of this study is to search for the underlying mechanism(s) of the post-HD augmentation of QRS-c and R-w.


METHODS
The sum of the amplitudes of ECG QRS-c and R-w, along with a host of other parameters (body weight, fluid volumes, echocardiographically-derived left ventricular dimensions and volumes, serum potassium, hemoglobin, hematocrit, and others) was measured, before and after HD, in 17 patients with end-stage renal failure.


RESULTS
While there were many correlations noted between the changes in the QRS-c and R-w and some of the above variables in numerous univariate analyses carried out, multivariate analyses did not identify any of the examined variables as exerting an independent influence on the observed ECG changes after HD.


CONCLUSIONS
Augmentation of QRS-c and R-w following HD is engendered by an interplay of a decrease in the LVEDD/LVEDV, and K+, loss of fluid volume, and a rise in Hb and Ht, without any of the above being an independent variable; also other factor(s) (e.g., increase in the body electrical impedance) exerting an influence in this ECG phenomenon cannot be excluded.
Drighil
Abdenasser
A
Department of Cardiology, Ibn Rochd University Hospital, Casablanca, Morocco.
Madias
John E
JE
Mosalami
Hanane El
HE
Badaoui
Nadia El
NE
Bennis
Ahmed
A
Mouine
Bahija
B
Fadili
Wafae
W
Ramdani
Beenyouness
B
D000293:Adolescent; D000328:Adult; D015150:Echocardiography, Doppler; D004562:Electrocardiography; D005260:Female; D006321:Heart / Q000503:physiopathology*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000503:physiopathology / Q000628:therapy*; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis