OR46. Increased of Ventricular Repolarization Abnormalities in Hemodialytic End-Stage Renal Disease

Cardiac or ventricular arrhythmia risks, including sudden cardiac death, are highly increased in patients with CKD, especially when reaching end-stage renal disease (ESRD). Several electrocardiographic (ECG) methods can be used to assess ventricular arrhythmia risk on the standard 12-lead ECG. This study aimed to evaluate ventricular repolarization abnormalities in patients with hemodialytic ESRD.

Fifty-three patients with hemodialytic ESRD and thirty-two pre-dialytic CKD as controls were enrolled in the study. ECG parameters: QT, QTc, Tp-e, Tp-e/QT, and Tp-e/QTc were measured manually using callipers on ECG recordings from all participants. The normality of the data was analyzed with the Shapiro-Wilk test. The independent-samples T-test for normal distribution and the Mann-Whitney U test for abnormal distribution were used for analysis. Mean age in hemodialytic and pre-dialytic groups were 46.6±11.5 and 56.1±10.6 years old, respectively. Mean creatinine serum in hemodialytic and pre-dialytic groups were 9.9±4.7 and 2.4±0.7 mg/dL. Ventricular repolarization abnormalities in hemodialytic compared to pre-dialytic group: QTc (448.2±33.9 vs. 427.9±31.3 msec, p = 0.007), Tp-e (80[40:130] vs. 70[40:120] msec, p = 0.022), Tp-e/QT (0.23±0.06 vs. 0.20±0.05, p = 0.043) were found to be significantly different. While QT (360.4±47.8 vs. 355.9±36.6 msec, p = 0.646) and Tp-e/QTc (0.18[0.08:0.33] vs. 0.16[0.09:0.25], p = 0.196) were increased in hemodialytic group but not significantly different.

Ventricular repolarization abnormalities were found to be increased in patients with hemodialytic end-stage renal disease. Measuring ECG parameters of ventricular repolarization may help to identify risk for arrhythmogenesis and sudden cardiac death.