Comparison of the Effect of Electrolyte Changes on Ecgs of Patients Presented in Emergency Room With Renal Failure During Pre and Post Haemodialysis and Their Correlation.

Indian Journal of Applied Basic Medical Sciences
Year: 2020, Volume: 22(A), Issue. (1)
First page: (210) Last page: (225)
Online ISSN: 2249-7935
Print ISSN: 0975-8917
doi:10.48165/ijabms.2020.22133

Comparison of the Effect of Electrolyte Changes on Ecgs of Patients Presented  in Emergency Room With Renal Failure During Pre and Post Haemodialysis and  Their Correlation.
Chirag J Patel1, Shruti Sangani2
M.D.-Anesthetics.  Emergency Medicine Department  M.S.-General Surgery. Emergency Medicine  Department Emergency  Medicine Department B.J. Medical college and civil Hospital asarwa ahmedabad. 
Corresponding author email id: bittu425@yahoo.co.in

Online Published on 02-Jan-2020

ABSTRACT

Introduction Cardiovascular disease is a most common reason for mortality and morbidity  among patients on haemodialysis. It is responsible for up to 30% of sudden death  among patients during and sometime after dialysis Methods In this prospective study, 76 patients were recruited; all patients with Age >  18 years of renal failure, and all patients providing consent and undergoing first time haemodialysis treatment were included. The mean duration for sessions of the  dialysis was around 3 hours. Patients with Known case of arrhythmias on  antiarrhythmic drugs, Known case of IHD and Congenital long QT syndrome,  Patients on drug that might have an effect on QT interval, Post CPR, Cardiac  resynchronization therapy, Pacemaker, and an implantable cardioverter defibrillator were excluded from the study.  Results  Out of 76 patients 46 were male and 30 were female. Atrial arrhythmias were seen  more commonly than ventricular arrhythmias. 42 patients had pre-HD ECG  changes; Out of them Sinus tachycardia was seen in 11 patients; 13 patients had  atrial premature beats; 6 patients had ventricular premature contraction and 12  patients had ST-T changes were seen in ECG changes before HD. 12 patients  without pre-HD ECG changes developed ECG changes post-HD. Total 23 patients  had ECG changes after HD. Out of them Sinus tachycardia was seen in 10 patients; 8 patients had atrial premature beats; 3 patients had ventricular premature  contraction and 2 patients had ST-T changes were seen in ECG changes after HD.  Conclusion  There were significant changes in ECG parameters and serum electrolytes  during haemodialysis. However, there was no obvious influence of serum K+ on  the ECGs in a patient with renal failure, apart from the net change of serum K+ on  the amplitude T wave difference, during haemodialysis. More evaluation with a  larger sample to see the effect of electrolyte on ECG changes might be required.  The prolonged QTc interval was weakly negative correlated with serum potassium.  Post haemodialysis ECG would effectively identify patients whose repolarization  substitute increase after dialysis sessions. In these individuals, a dialysis regimen  can be selected which is rarely change ventricular repolarization.

Keywords

haemodialysis , antiarrhythmic drugs, Post CPR, Cardiac  resynchronization therapy , QT interval