Bradycardic Rhythms During Peritoneal Dialysis

Peritoneal dialysis has been utilized extensively in the management of patients with acute and chronic renal failure and in acute drug intoxication. Although many of the hazards of this procedure have been discussed in detail, 1-6 the occurrence of vagal-induced bradycardia and hypotension have been mentioned only briefly. 2,7,8 That serious and life-threatening arrhythmias may be produced by peritoneal dialysis-induced vagotonia has not been emphasized. This report stresses the potentially serious nature of such arrhythmias observed during the performance of peritoneal dialysis in three patients. Patient Summaries Patient 1. —A 54-year-old woman was admitted to the Portsmouth Naval Hospital in December 1969 following the onset of pericarditis associated with chronic renal failure. Physical examination showed the blood pressure to be 136/92 mm Hg and the pulse rate, 94 beats per minute. Moderate cardiomegaly and a typical three-component pericardial friction rub were present. Pitting edema was present in the lower extremities.