A QRS duration of 120 ms or greater was most predictive of hyperkalemia in ESRD patients, while overall ECG parameters showed weak correlations with serum potassium (r2=0.02-0.12; P<0.05).
Observational (n=96)
Do abnormal ECG parameters accurately predict hyperkalemia in patients with end-stage renal disease?
In ESRD patients, standard ECG parameters like T/R ratio and PR interval correlate poorly with serum potassium levels, though a QRS duration ≥120 ms is predictive of hyperkalemia.
Effect estimate: r2 0.02 to 0.12
p-value: p=<0.05
Hyperkalemia is one of the more common acute life-threatening metabolic emergencies. The aim of our study is to determine the correlation and accuracy of abnormal ECG parameters as a function of serum potassium concentration in the end-stage renal disease (ESRD) population. We performed a retrospective chart review of emergency department patients presenting with ESRD and receiving emergent hemodialysis treatment. A total of 96 patients, each with five independent ED visits, provided 480 sets of ECGs and electrolytes. Of these, four ECGs were excluded for inability to interpret, leaving a total of 476 patient encounters that met all inclusion criteria. Linear regression analysis on the limited data set for serum potassium versus T/R in V2, V3, and V4, PR, and QRS found weak correlations (r2 = 0.02 to 0.12) with statistical significance <0.05 level for T/R in V2, V3, and V4. In summary, we found that a QRS duration of 120 ms or greater is most predictive of hyperkalemia in the ESRD population. On the other hand, T/R ratio, PR interval and QRS duration have poor correlations with serum potassium and are not predictive of hyperkalemia in patients with ESRD.
Rafique et al. (Fri,) conducted a observational in End-stage renal disease (n=96). Electrocardiogram parameters was evaluated on Correlation of abnormal ECG parameters with serum potassium concentration (r2 0.02 to 0.12, p=<0.05). A QRS duration of 120 ms or greater was most predictive of hyperkalemia in ESRD patients, while overall ECG parameters showed weak correlations with serum potassium (r2=0.02-0.12; P<0.05).