Key result
Hemodialysis is linked to an acute ~22 mm Hg drop in systolic blood pressure.
Why the study?
Changes in electrocardiographic parameters after hemodialysis and their relationship with hemodynamics and body weight are not well characterized in pediatric patients.
Does hemodialysis acutely alter hemodynamic and electrocardiographic parameters in pediatric and young adult patients with CKD stage 5?
Cross-Sectional (n=20)
No
Does hemodialysis acutely alter hemodynamic and electrocardiographic parameters in pediatric and young adult patients with CKD stage 5?
Mean Difference: 22.25 (95% CI 15–29.4)
Absolute Event Rate: 106.75% vs 129%
p-value: p=0.001
In pediatric and young adult patients, hemodialysis causes significant acute drops in blood pressure and can induce ventricular strain patterns, though it does not significantly alter QTc or QRS intervals.
Acute BP drops during pediatric hemodialysis warrant monitoring; hypothesis-generating for strain patterns in youth with limited prior data.
Background and Aim: Changes in electrocardiographic parameters are reported afterhemodialysis (HD). This study determines the alternations in electrocardiographic parameters,hemodynamics, and body weight post-HD.Methods: Electrocardiography was evaluated pre- and post-dialysis in 20 patients (55%males) aged 16.25±6.25 years. Changes in electrocardiographic parameters were comparedconsidering changes in weight (post-dialysis and between dialysis sessions), blood pressure(BP) indices, and the occurrence of intra-dialysis hypotension (IDH).Results: A significant decrease was observed in weight, systolic, diastolic, and mean arterialBPs post-dialysis (P<0.05, for all). No substantial changes in durations of PR interval, QTinterval corrected for heart rate, and QRS complex, as well as QT dispersion, were foundpost-dialysis (P>0.05 for all). Hemodynamic and electrocardiographic alternations were notsignificantly different between cases with adequate versus inadequate weight gain (P>0.05for all). Meanwhile, dialysis-induced ventricular strain patterns (ST-T segment changes) werefound in 20% of patients, including three cases with inadequate weight gain inter-dialysis. Inone case, electrocardiographic findings of hyperkalemia resolved post-dialysis. Whereas, theleft ventricular strain pattern appeared in one other case.Conclusion: HD is associated with significant acute changes in systolic and diastolic BP andmean arterial pressure (MAP). These changes, if repeated frequently, can result in myocardialischemia and infarction. HD protects the heart against hyperkalemia, and thereby arrhythmia;however, it causes ventricular strain patterns, which a predictive of adverse cardiovascularoutcomes. Evaluating the long-term complications of hemodynamic and electrocardiogramchanges in pediatric HD cases is suggested.
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Naseri et al. (2025) conducted a cross-sectional in Chronic kidney disease undergoing hemodialysis (n=20). Hemodialysis vs. Pre-hemodialysis baseline was evaluated on Change in systolic blood pressure (mm Hg) (MD 22.25, 95% CI 15-29.4, p=0.001). Hemodialysis was associated with significant acute decreases in systolic blood pressure (mean decrease 22.25 mm Hg), diastolic blood pressure, and weight, but no substantial changes in PR, QTc, or QRS intervals.
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