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Comparison of pathological electrocardiographic changes between long-term kidney transplant recipients and hemodialysis patients

Yıl 2024, , 513 - 517, 27.09.2024
https://doi.org/10.32322/jhsm.1519695

Öz

Aims: We aimed to reveal electrocardiographic changes in kidney transplant recipients (KTRs) compared with hemodialysis patients.
Methods: We included 70 KTRs who had underwent a kidney transplantation for more than one year and 84 patients who had been on hemodialysis for more than one year. We recorded age, sex, body-mass index (BMI) (kg/m2), primary disease (makes chronic kidney disease) and duration of hemodialysis treatment. Standard measurements such as heart rate (HR), P wave, PR interval, P axis, QRS complex, QRS axis, T axis, QT interval and QTc interval were performed for all electrocardiography (ECG).
Results: KTRs were younger than the hemodialysis patients group (HPG) (31.5 vs. 54.5, p<0.001). The female gender was more common in the HPG (54.8% vs. 28.6%, p=0.001). Diabetes mellitus (DM) and hypertension (HT) were more common in the HPG (21.4% vs. 7.1% and 47.6% vs. 15.7% respectively, p<0.001). There was no statistically significant difference between KTRs and HPG in terms of heart rate, P axis, P-wave, QRS axis, QRS complex, RR interval, while T axis was higher in HPG (65o vs. 40.5o, p=0.001), PR interval was longer in HPG (152 msec vs 144 msec, p=0.020), QT interval was longer in HPG (385 msec vs 360 msec, p<0.001), QTc was longer in HPG (463 msec vs 415.5 msec, p<0.001).
Conclusion: In the long term after kidney transplantation, improvement of ECG pathologies such as prolonged QT and abnormal T axis seen in HPG may be the result of an improved uremic milieu and reduced inflammation in KTRs.

Etik Beyan

The study was retrospective, single-center, and approved by the Clinical Research Ethics Committee of Health Science Of University Gazi Yaşargil Training and Research Hospital (Decision Date and Number: 19.09.2023/524). It was performed as per the principles of the Declaration of Helsinki.

Destekleyen Kurum

no

Proje Numarası

no

Kaynakça

  • Johansen KL, Chertow GM, Gilbertson DT, et al. US Renal Data System 2021 Annual Data Report: Epidemiology of Kidney Disease in the United States. Am J Kidney Dis. 2022;79(4 Suppl 1):A8-A12.
  • Ortiz A, Covic A, Fliser D, et al. Epidemiology, contributors to, and clinical trials of mortality risk in chronic kidney failure. Lancet. 2014;383(9931):1831-1843.
  • Genovesi S, Boriani G, Covic A, et al. EUDIAL working group of ERA-EDTA. Sudden cardiac death in dialysis patients: different causes and management strategies. Nephrol Dial Transplant. 2021;36(3):396-405.
  • Saran R, Robinson B, Abbott KC, et al. US Renal Data System 2018 Annual Data Report: Epidemiology of Kidney Disease in the United States. Am J Kidney Dis. 2019;73(3 Suppl 1):A7-A8.
  • Wilson GJ, Van K, O’Lone E, et al. Range and consistency of cardiovascular outcomes reported by clinical trials in kidney transplant recipients: a systematic review. Transplant Direct. 2022;9(1):e1398.
  • Di Iorio B, Bellasi A. QT interval in CKD and haemodialysis patients. Clin Kidney J. 2013;6(2):137-1343.
  • Goldberger AL, Goldberger ZD, Shvilkin A. Goldberger’s Clinical Electrocardiography a Simplified Approach 8th ed. Elsevier Saunders, 2013.
  • Salles GF, Xavier SS, Sousa AS, Hasslocher-Moreno A, Cardoso CR. T-wave axis deviation as an independent predictor of mortality in chronic Chagas’ disease. Am J Cardiol. 2004;93(9): 1136-1140.
  • Jankowski J, Floege J, Fliser D, Böhm M, Marx N. Cardiovascular disease in chronic kidney disease: pathophysiological insights and therapeutic options. Circulation. 2021;143(11):1157-1172.
  • Boriani G, Savelieva I, Dan GA, et al. Chronic kidney disease in patients with cardiac rhythm disturbances or implantable electrical devices: clinical significance and implications for decision making-a position paper of the European Heart Rhythm Association endorsed by the Heart Rhythm Society and the Asia Pacific Heart Rhythm Society. Europace. 2015;17(8):1169-1196.
  • Xu C, Tsihlis G, Chau K, Trinh K, Rogers NM, Julovi SM. Novel perspectives in chronic kidney disease-specific cardiovascular disease. Int J Mol Sci. 2024;25(5):2658.
  • Akcay M, Yıldırım U. Effect of dialysis and transplantation on myocardial repolarization parameters and P-wave dispersion in chronic kidney disease. J Arrhythm. 2021;37(2):348-355.
  • Genovesi S, Rossi E, Nava M, et al. A case series of chronic haemodialysis patients: mortality, sudden death, and QT interval. Europace. 2013;15(7):1025-1033.
  • Sherif KA, Abo-Salem E, Panikkath R, et al. Cardiac repolarization abnormalities among patients with various stages of chronic kidney disease. Clin Cardiol. 2014;37(7):417-421.
  • Oktavia D, Nasution SA, Setiati S. The clinical factors’prediction of increased intradialytic QT dispersion on the electrocardiograms of chronic hemodialysis patients. Saudi J Kidney Dis Transpl. 2013;24(2):274-280.
  • Hage FG, de Mattos AM, Khamash H, et al. QT prolongation is an independent predictor of mortality in end-stage renal disease. Clin Cardiol. 2010;33(6):361-366.
  • Beaubien ER, Pylypchuk GB, Akhtar J, et al. Value of corrected QT interval dispersion in identifying patients initiating dialysis at increased risk of total and cardiovascular mortality. Am J Kidney Dis. 2002;39(4):834-842.
  • Monfared A, Ghods AJ. Improvement of maximum corrected QT and corrected QT dispersion in electrocardiography after kidney transplantation. Iran J Kidney Dis. 2008;2(2):95-98.
  • Monfared A, Atrkar Roshan Z, Salari A, et al. QT intervals in patients receiving a renal transplant. Exp Clin Transplant. 2012; 10(2):105-109.
  • Durak MI, Algul Durak B. The comparison of QTc dispersion between renal transplant recipients and healthy individuals. Cureus. 2022;14(12):e32458.
  • Liu P, Wang L, Han D, Sun C, Xue X, Li G. Acquired long QT syndrome in chronic kidney disease patients. Ren Fail. 2020; 42(1):54-65.
  • Robison LB, Brady WJ, Robison RA, Charlton N. QT interval prolongation and the risk of malignant ventricular dysrhythmia and/or cardiac arrest: Systematic search and narrative review of risk related to the magnitude of QT interval length. Am J Emerg Med. 2021;49:40-47.
  • Scherer ML, Aspelund T, Sigurdsson S, et al. Abnormal T-wave axis is associated with coronary artery calcification in older adults. Scand Cardiovasc J. 2009;43(4):240-248.
Yıl 2024, , 513 - 517, 27.09.2024
https://doi.org/10.32322/jhsm.1519695

Öz

Proje Numarası

no

Kaynakça

  • Johansen KL, Chertow GM, Gilbertson DT, et al. US Renal Data System 2021 Annual Data Report: Epidemiology of Kidney Disease in the United States. Am J Kidney Dis. 2022;79(4 Suppl 1):A8-A12.
  • Ortiz A, Covic A, Fliser D, et al. Epidemiology, contributors to, and clinical trials of mortality risk in chronic kidney failure. Lancet. 2014;383(9931):1831-1843.
  • Genovesi S, Boriani G, Covic A, et al. EUDIAL working group of ERA-EDTA. Sudden cardiac death in dialysis patients: different causes and management strategies. Nephrol Dial Transplant. 2021;36(3):396-405.
  • Saran R, Robinson B, Abbott KC, et al. US Renal Data System 2018 Annual Data Report: Epidemiology of Kidney Disease in the United States. Am J Kidney Dis. 2019;73(3 Suppl 1):A7-A8.
  • Wilson GJ, Van K, O’Lone E, et al. Range and consistency of cardiovascular outcomes reported by clinical trials in kidney transplant recipients: a systematic review. Transplant Direct. 2022;9(1):e1398.
  • Di Iorio B, Bellasi A. QT interval in CKD and haemodialysis patients. Clin Kidney J. 2013;6(2):137-1343.
  • Goldberger AL, Goldberger ZD, Shvilkin A. Goldberger’s Clinical Electrocardiography a Simplified Approach 8th ed. Elsevier Saunders, 2013.
  • Salles GF, Xavier SS, Sousa AS, Hasslocher-Moreno A, Cardoso CR. T-wave axis deviation as an independent predictor of mortality in chronic Chagas’ disease. Am J Cardiol. 2004;93(9): 1136-1140.
  • Jankowski J, Floege J, Fliser D, Böhm M, Marx N. Cardiovascular disease in chronic kidney disease: pathophysiological insights and therapeutic options. Circulation. 2021;143(11):1157-1172.
  • Boriani G, Savelieva I, Dan GA, et al. Chronic kidney disease in patients with cardiac rhythm disturbances or implantable electrical devices: clinical significance and implications for decision making-a position paper of the European Heart Rhythm Association endorsed by the Heart Rhythm Society and the Asia Pacific Heart Rhythm Society. Europace. 2015;17(8):1169-1196.
  • Xu C, Tsihlis G, Chau K, Trinh K, Rogers NM, Julovi SM. Novel perspectives in chronic kidney disease-specific cardiovascular disease. Int J Mol Sci. 2024;25(5):2658.
  • Akcay M, Yıldırım U. Effect of dialysis and transplantation on myocardial repolarization parameters and P-wave dispersion in chronic kidney disease. J Arrhythm. 2021;37(2):348-355.
  • Genovesi S, Rossi E, Nava M, et al. A case series of chronic haemodialysis patients: mortality, sudden death, and QT interval. Europace. 2013;15(7):1025-1033.
  • Sherif KA, Abo-Salem E, Panikkath R, et al. Cardiac repolarization abnormalities among patients with various stages of chronic kidney disease. Clin Cardiol. 2014;37(7):417-421.
  • Oktavia D, Nasution SA, Setiati S. The clinical factors’prediction of increased intradialytic QT dispersion on the electrocardiograms of chronic hemodialysis patients. Saudi J Kidney Dis Transpl. 2013;24(2):274-280.
  • Hage FG, de Mattos AM, Khamash H, et al. QT prolongation is an independent predictor of mortality in end-stage renal disease. Clin Cardiol. 2010;33(6):361-366.
  • Beaubien ER, Pylypchuk GB, Akhtar J, et al. Value of corrected QT interval dispersion in identifying patients initiating dialysis at increased risk of total and cardiovascular mortality. Am J Kidney Dis. 2002;39(4):834-842.
  • Monfared A, Ghods AJ. Improvement of maximum corrected QT and corrected QT dispersion in electrocardiography after kidney transplantation. Iran J Kidney Dis. 2008;2(2):95-98.
  • Monfared A, Atrkar Roshan Z, Salari A, et al. QT intervals in patients receiving a renal transplant. Exp Clin Transplant. 2012; 10(2):105-109.
  • Durak MI, Algul Durak B. The comparison of QTc dispersion between renal transplant recipients and healthy individuals. Cureus. 2022;14(12):e32458.
  • Liu P, Wang L, Han D, Sun C, Xue X, Li G. Acquired long QT syndrome in chronic kidney disease patients. Ren Fail. 2020; 42(1):54-65.
  • Robison LB, Brady WJ, Robison RA, Charlton N. QT interval prolongation and the risk of malignant ventricular dysrhythmia and/or cardiac arrest: Systematic search and narrative review of risk related to the magnitude of QT interval length. Am J Emerg Med. 2021;49:40-47.
  • Scherer ML, Aspelund T, Sigurdsson S, et al. Abnormal T-wave axis is associated with coronary artery calcification in older adults. Scand Cardiovasc J. 2009;43(4):240-248.
Toplam 23 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Kardiyoloji
Bölüm Orijinal Makale
Yazarlar

Süleyman Akkaya 0000-0003-3214-4837

Ümit Çakmak 0000-0003-0155-5633

Proje Numarası no
Yayımlanma Tarihi 27 Eylül 2024
Gönderilme Tarihi 20 Temmuz 2024
Kabul Tarihi 16 Ağustos 2024
Yayımlandığı Sayı Yıl 2024

Kaynak Göster

AMA Akkaya S, Çakmak Ü. Comparison of pathological electrocardiographic changes between long-term kidney transplant recipients and hemodialysis patients. J Health Sci Med /JHSM /jhsm. Eylül 2024;7(5):513-517. doi:10.32322/jhsm.1519695

Üniversitelerarası Kurul (ÜAK) Eşdeğerliği:  Ulakbim TR Dizin'de olan dergilerde yayımlanan makale [10 PUAN] ve 1a, b, c hariç  uluslararası indekslerde (1d) olan dergilerde yayımlanan makale [5 PUAN]

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Not:
Dergimiz WOS indeksli değildir ve bu nedenle Q olarak sınıflandırılmamıştır.

Yüksek Öğretim Kurumu (YÖK) kriterlerine göre yağmacı/şüpheli dergiler hakkındaki kararları ile yazar aydınlatma metni ve dergi ücretlendirme politikasını tarayıcınızdan indirebilirsiniz. https://dergipark.org.tr/tr/journal/2316/file/4905/show 


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