Abstract Background The kidneys play a crucial role in potassium homeostasis, and the importance of their contribution in the maintenance of potassium balance is reflected by the high rates of potassium disorders in patients with decreased kidney function. Individuals with chronic kidney disease (CKD) and those with end-stage kidney disease (ESKD) can experience both hyperkalemia and hypokalemia; Besides, abnormalities of potassium, rapid changes in potassium concentrations during the HD session, have been suggested as a potential cause of cardiac arrhythmia. Aim of the Work to investigate the relationship between Potassium kinetics inhemodialysis patients and interdialytic weight gain (IDWG), ECG changes and overall morbidity. Patients and Methods This prospective cohort study utilized a randomized sampling method to enroll 102 end-stage renal disease (ESRD) patients on regular hemodialysis from the hemodialysis unit at Nasr City Health Insurance Hospital. The cases were recruited over a three-month period, and the study was conducted from April 2023 to March 2024. Results This prospective cohort study of 102 ESRD patients on hemodialysis revealed a mean age of 58.0±13.0 years, with male predominance (74.5%) and a median dialysis duration of 5 years. Diabetic kidney disease (40.2%) and hypertension (48.9%) were the most common risk factors and comorbidities. ECG changes, observed in 29.4% of patients, were linked to older age, female gender, and higher inter-dialytic weight gain (IDWG). Overall morbidity (31.4%) was associated with older age, longer dialysis duration, pre-existing coronary artery disease, and ECG changes. Lower urea and bicarbonate levels post-dialysis also correlated with higher morbidity and IDWG. Conclusion Cardiovascular disease continues to be the leading cause of mortality including sudden cardiac deaths due to ventricular arrhythmias in patients undergoing hemodialysis. Current study shows that there are significant electrocardiographic changes present in patients hemodialysis which could be a pointer toward the future cardiovascular events. Therefore, ECG should be meticulously monitored in hemodialysis patients. However larger studies may highlight further knowledge to the existing information and better patient care.
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