What is the clinical evidence from this study?

Study design: Observational. Population: Chronic renal failure requiring hemodialysis (n=100). Intervention: Regular maintenance hemodialysis. Primary outcome: Clinically significant ventricular arrhythmias (>700 beats/24 h).

What question did this study set out to answer?

To assess the frequency and timing of cardiac arrhythmias in maintenance hemodialysis patients and evaluate relationships with cardiac function and mineral metabolism.

December 10, 2008The Nephron journals/Nephron journals

Cardiac Arrhythmias in Hemodialysis Patients

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Key result

Among hemodialysis patients, frequent ventricular arrhythmias were associated with a higher calcium phosphate product (p<0.005) and lower left ventricular fractional shortening (p<0.01).

Key Points

To assess the frequency and timing of cardiac arrhythmias in maintenance hemodialysis patients and evaluate relationships with cardiac function and mineral metabolism.
Evaluated 100 chronic renal failure patients undergoing regular maintenance hemodialysis using 72-hour Holter electrocardiographic monitoring initiated on the day of treatment.
Assessed cardiac structure and function via two-dimensional echocardiography and measured predialysis serum calcium and phosphorus concentrations.
Clinically significant ventricular arrhythmias (>700 premature ventricular contractions [PVCs]/24 h) occurred in 18 patients, primarily during and within 4 hours following hemodialysis.
Patients with frequent PVCs had a significantly higher calcium-phosphorus product (54.9 ± 3.5 vs. 43.8 ± 3.2 in no-arrhythmia and 43.0 ± 1.8 in sporadic groups; p < 0.005) and lower left ventricular fractional shortening (30.7 ± 1.8% vs. 40.7 ± 1.9% and 37.7 ± 1.1%; p < 0.01).
Patients with frequent premature atrial contractions exhibited significantly larger left atrial end-diastolic dimensions (42.1 ± 1.2 mm vs. 36.5 ± 1.1 mm and 38.1 ± 0.9 mm; p < 0.01).

Study Design

Type

Observational (n=100)

Structured PICO

Population

100 patients undergoing regular maintenance hemodialysis for chronic renal failure evaluated by 72-hour Holter ECG monitoring.

Outcome

Cardiac arrhythmias evaluated by 72-hour Holter ECG monitoringsurrogate

Impaired cardiac performance and high calcium phosphate product predialysis are correlated with an increased incidence of ventricular arrhythmias in hemodialysis patients.

Discussion

No takes yet. Share an insight, caveat, or question.

Implication

Should not yet change practice in hemodialysis; hypothesis-generating for calcium-phosphate and LV-targeted interventions.

Cite This Study

Kimura et al. (2008) conducted an observational in Chronic renal failure requiring hemodialysis (n=100). Regular maintenance hemodialysis was evaluated on Clinically significant ventricular arrhythmias (>700 beats/24 h). Among hemodialysis patients, frequent ventricular arrhythmias were associated with a higher calcium phosphate product (p<0.005) and lower left ventricular fractional shortening (p<0.01).

synapsesocial.com/papers/6a95b63c4b611e179c09e1bb https://doi.org/10.1159/000185745

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Cardiac Arrhythmias in Hemodialysis Patients

Key Points

Study Design

Structured PICO

Discussion

Implication

Cite This Study

Cardiac Arrhythmias in Hemodialysis Patients

Key Points

Study Design

Structured PICO

Discussion

Implication

Cite This Study

Also Consider

Also Consider