Hyperkalaemia and haemodialysis patients: eletrocardiographic changes.
BACKGROUND
Patients with end-stage renal disease (ESRD) present hydro-electrolytic alterations due to the lack of adequate regulation of the internal medium. Of these alterations hyperkalaemia is frequent and produce neuromuscular symptoms, electrocardiographic changes and arrhythmias. Literature affirms that patients with ESRD present less prominent hyperkalaemia-related electrocardiographic changes than those patients with normal renal function.


OBJECTIVE
To evaluate electrocardiographic alterations related with potassium in our ESRD patients and to compare the obtained results with those previously reported.


METHODS
Descriptive, cross-sectional and prospective study in hospital haemodialysis (HD) patients. Pre- and post-HD serum potassium and other electrolyte concentrations were measured, and simultaneous 12-lead electrocardiogram (ECG) obtained at the first session of the week. An expert evaluated all ECG's.


RESULTS
39 patients were included in the study, 58.9% were women and 41.1% men, with a mean age 67.35 years (24-89). Serum potassium pre-HD range was 2.8 to 7.4 mEq/l (mean 5.07 mEq/L), 29.4% of the sample presented levels > or = 5.5 mEq/l and the most frequent alteration in the ECG was high and peaked T waves in leads V2 to V4. In the hyperkalaemia cases, the mean elevation of T wave was 7 mm. In 2 hyperkalaemia patients there was no elevation of T wave: one T wave was negative (K+ = 6 mEq/L) and another one stayed normal (K+ = 5.6 mEq/L).


CONCLUSIONS
The ECG continues to be a good tool of early hyperkalaemia detection, contributing to estimating severity. Patients with ESRD present electrocardiographic alterations similar to the healthy population.
Cobo Sánchez
José Luis
JL
Hemodialysis Unit, Hospital Universitario Marqués de Valdecilla, Santander, Spain. jlcobosanchez@gmail.com
Alconero Camarero
Ana Rosa
AR
Casaus Pérez
María
M
Maza Sota
Ma Angeles
MA
Villa Llamazares
Camino
C
Hiquera Roldán
Carmen
C
Menezo Viadero
Raquel
R
Alonso Nates
Rosa
R
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001145:Arrhythmias, Cardiac / Q000175:diagnosis / Q000209:etiology; D002118:Calcium / Q000097:blood; D003404:Creatinine / Q000097:blood; D003430:Cross-Sectional Studies; D042241:Early Diagnosis; D004562:Electrocardiography / Q000379:methods* / Q000592:standards; D005260:Female; D006801:Humans; D006947:Hyperkalemia / Q000097:blood / Q000175:diagnosis* / Q000209:etiology; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009730:Nursing Assessment / Q000379:methods; D015403:Nursing Evaluation Research; D011188:Potassium / Q000097:blood; D011446:Prospective Studies; D006435:Renal Dialysis / Q000379:methods; D012720:Severity of Illness Index; D012964:Sodium / Q000097:blood; D014508:Urea / Q000097:blood
D014508:Urea; D012964:Sodium; D003404:Creatinine; D011188:Potassium; D002118:Calcium