Key result
Prolonged QTc interval in end-stage renal disease patients undergoing hemodialysis was associated with higher mortality, and rare pathogenic genetic variants were found in 21.7% of patients with post-dialysis QTc prolongation.
Why the study?
Does the presence of QTc interval alterations and rare genetic variants predict sudden cardiac death in end-stage renal disease patients on hemodialysis?
Cohort (n=111)
No
Does the presence of QTc interval alterations and rare genetic variants predict sudden cardiac death in end-stage renal disease patients on hemodialysis?
Genetic background and post-dialysis QTc prolongation may be important determinants of sudden cardiac death risk in end-stage renal disease patients.
Post-dialysis QTc prolongation may flag genetic SCD risk in small ESRD subsets; leaves open whether monitoring or screening alters outcomes.
BACKGROUND: Patients with end-stage renal disease have very high mortality. In individuals on hemodialysis, cardiovascular deaths account for ~50% of all deaths in this population, mostly due to arrhythmia. To determine the causes of these arrhythmic deaths is essential in order to adopt preventive strategies. The main objective of this study was to investigate whether, the presence of QTc interval alterations, from electrolyte abnormalities or presence of rare genetic variants, could have a relationship with sudden arrhythmogenic deaths in end-stage renal disease patients. METHODS: We recorded the pre- and post-dialysis QTc interval in 111 patients undergoing hemodialysis. In 47 of them, we analyzed 24 SCD-related genes including the most prevalent genes associated with long QT syndrome using a custom resequencing panel. RESULTS: We found a positive although not significant association between the presence of long QTc and mortality in a subset of end-stage renal disease patients. In addition, in five patients with long QTc only after dialysis (21.7%) we detected rare potentially pathogenic genetic variants. Three out of these five carriers subsequently died suddenly. CONCLUSIONS: Genetic background may be determinant in the risk of sudden cardiac death in these patients. We recommend evaluating the QTc interval before and after hemodialysis, and performing a genetic analysis of individuals with long QTc after hemodialysis.
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Coll et al. (2018) conducted a cohort in End-stage renal disease (ESRD) (n=111). Prolonged QTc interval vs. Normal QTc interval was evaluated on Mortality (p=0.144). Prolonged QTc interval in end-stage renal disease patients undergoing hemodialysis was associated with higher mortality, and rare pathogenic genetic variants were found in 21.7% of patients with post-dialysis QTc prolongation.
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