Key result
QTc >500 ms linked to ~67% higher all-cause mortality and increased MACE in dialysis patients.
Why the study?
Prolonged QT interval is common in ESRD on dialysis, but its long-term cardiovascular implications remain unclear.
Does a prolonged QTc interval (> 500 ms) increase the risk of adverse cardiovascular outcomes and mortality in adult patients with ESRD on dialysis?
Does a prolonged QTc interval (> 500 ms) increase the risk of adverse cardiovascular outcomes and mortality in adult patients with ESRD on dialysis?
In patients with ESRD on dialysis, a prolonged QTc interval (>500 ms) is a significant independent predictor of all-cause mortality and major adverse cardiovascular events.
Supports QTc monitoring for risk stratification in ESRD dialysis; leaves open whether correction improves outcomes.
Background Prolonged QT interval is common in end‐stage renal disease (ESRD) on dialysis, but its long‐term cardiovascular (CV) implications remain unclear. Methods Using TriNetX network (2010–2024), we identified adults with ESRD on dialysis and categorized them by QTc status. After 1:1 propensity score matching ( n = 3428/group), outcomes (hazard ratio [HR]) were assessed using Cox regression. Results Prolonged QTc (> 500 ms) was associated with higher risk of all‐cause mortality (HR 1.67; p < 0.001), MACEs (HR 1.40; p < 0.001), cardiac arrest (HR 1.75; p < 0.001), sustained ventricular arrhythmia (HR 1.66; p < 0.001), new‐onset atrial fibrillation (HR 1.12; p = 0.01), and acute myocardial infarction (HR 2.19; p < 0.001). Conclusions In ESRD patients on dialysis, prolonged QT interval was independently associated with adverse CV outcomes and mortality.
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Pham et al. (2026) studied this question. In ESRD patients on dialysis, QTc >500 ms increased all-cause mortality risk by 67% and major cardiovascular events by 40%.
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