Key result
The time-warping-based ECG biomarker dw strongly correlated with relative variations in blood potassium concentration (median correlation coefficient 0.90).
Why the study?
End-stage renal disease patients on hemodialysis are at high risk of arrhythmias and sudden cardiac death from blood potassium changes, creating a need for noninvasive potassium monitoring.
Does the ECG biomarker dw accurately reflect blood potassium concentration changes in ESRD patients undergoing hemodialysis?
Observational (n=12)
Does the ECG biomarker dw accurately reflect blood potassium concentration changes in ESRD patients undergoing hemodialysis?
The ECG biomarker dw strongly correlates with blood potassium changes, suggesting its potential for non-invasive hyperkalemia monitoring in hemodialysis patients.
dw may enable noninvasive [K+] monitoring in HD; leaves open clinical validation before practice change.
End-stage renal disease (ESRD) patients undergoing hemodialysis (HD) are at high risk of arrhythmias and sudden cardiac death as a result of blood potassium concentration ([K+ ]) changes. The aim of this study is to investigate if dw, a time-warping-based electrocardiogram (ECG) biomarker of T-wave morphology changes, reflects [K+] evolution in HD patients, facilitating noninvasive [K+] monitoring and avoiding in-hospital blood tests analysis. 48-hour ECGs and a set of hourly-collected blood samples from 12 ESRD patients were acquired and analyzed. dw was calculated between a reference T-wave, measured at the end of the HD session, and the T-waves corresponding to each hour along the whole HD session, when [K+] was measured from blood samples. The values of dw correlated with the relative variations in [K+] with respect to the reference value (end of HD, ¿[K+ ]), with a median (interquartile) correlation coefficient of 0.90 (0.30), evidencing a strong relation between them. Our findings support the use of dw as a surrogate of ¿[K+], suggesting a potential use of dw for non-invasive hyperkalemia monitoring both in hospital and ambulatory settings.
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Palmieri et al. (2019) conducted an observational in End-stage renal disease (ESRD) undergoing hemodialysis (n=12). dw (time-warping-based ECG biomarker) vs. Blood potassium concentration was evaluated on Correlation between dw and relative variations in blood potassium concentration (median correlation coefficient 0.90). The time-warping-based ECG biomarker dw strongly correlated with relative variations in blood potassium concentration (median correlation coefficient 0.90).
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