Key result
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).
Why the study?
Hyperkalemia is a common life-threatening emergency, but the correlation and accuracy of abnormal ECG parameters across serum potassium concentrations in patients with ESRD required evaluation.
Do abnormal ECG parameters accurately predict hyperkalemia in patients with end-stage renal disease?
Observational (n=96)
Do abnormal ECG parameters accurately predict hyperkalemia in patients with end-stage renal disease?
Effect estimate: r2 0.02 to 0.12
p-value: p=<0.05
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.
ECG parameters should not replace potassium measurement in ESRD; cross-sectional data leaves open QRS duration's predictive utility.
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.
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Rafique et al. (2022) conducted an 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).
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