title: Hyperkalaemia and haemodialysis patients: eletrocardiographic changes.
abstract: 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.
authors.affiliation: Hemodialysis Unit, Hospital Universitario Marqués de Valdecilla, Santander, Spain. jlcobosanchez@gmail.com
authors.forename: José Luis
authors.initials: JL
authors.lastname: Cobo Sánchez
authors.forename: Ana Rosa
authors.initials: AR
authors.lastname: Alconero Camarero
authors.forename: María
authors.initials: M
authors.lastname: Casaus Pérez
authors.forename: Ma Angeles
authors.initials: MA
authors.lastname: Maza Sota
authors.forename: Camino
authors.initials: C
authors.lastname: Villa Llamazares
authors.forename: Carmen
authors.initials: C
authors.lastname: Hiquera Roldán
authors.forename: Raquel
authors.initials: R
authors.lastname: Menezo Viadero
authors.forename: Rosa
authors.initials: R
authors.lastname: Alonso Nates
mesh_terms: 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
chemical_list: D014508:Urea; D012964:Sodium; D003404:Creatinine; D011188:Potassium; D002118:Calcium