Retrospective analysis of cisapride‐induced QT changes in end‐stage renal disease patients

BACKGROUND: This study involves a retrospective in-patient chart review of end-stage renal disease (ESRD) patients receiving haemodialysis to observe if cisapride significantly increases heart rate (HR), QT, and corrected QT (QTc) intervals on 12-lead electrocardiograms (ECGs). METHODS: Medical records for 23 patients who were being treated with chronic maintenance haemodialysis and had >/=2 ECGs while on cisapride and >/=2 ECGs while off cisapride were obtained and reviewed. HR, QT, and QTc on all 12-lead ECGs, reason for admission, and past medical history were analysed. RESULTS: A total of 529 ECGs (279 on/250 off cisapride) for 23 patients were included. The results, as calculated by each patient's individual averages (n=23), on vs off cisapride respectively, were HR, 88+/-14 vs 84+/-17 beats/min (P:=0.18); QT, 373+/-39 vs 382+/-45 ms (P:=0.24); and QTc, 443+/-27 vs 441+/-21 ms (P:=0.39). No significant difference was found in the number of admissions per month while on or off cisapride. No patient had an average QTc on or off cisapride that was >500 ms. One patient died from ventricular arrhythmia 12 days after discontinuing cisapride. The patient's QTc was significantly longer on vs off cisapride (487 vs 462 ms, P:=0. 007); however, this patient had an extensive cardiac history and multiple syncopal episodes prior to the use of cisapride. CONCLUSIONS: This study found no significant overall difference in HR, QT, and QTc interval or admissions/month on vs off cisapride in ESRD patients receiving haemodialysis.