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1000 Titel
  • Large potassium shifts during dialysis enhance cardiac repolarization instability
1000 Autor/in
  1. Schuettler, Dominik |
  2. Schönermarck, Ulf |
  3. Wenner, Felix |
  4. Toepfer, Marcell |
  5. Rizas, Konstantinos D. |
  6. Bauer, Axel |
  7. Brunner, Stefan |
  8. Hamm, Wolfgang |
1000 Erscheinungsjahr 2020
1000 Publikationstyp
  1. Artikel |
1000 Online veröffentlicht
  • 2020-10-15
1000 Erschienen in
1000 Quellenangabe
  • 34(4):1301-1305
1000 Copyrightjahr
  • 2020
1000 Lizenz
1000 Verlagsversion
  • https://doi.org/10.1007/s40620-020-00880-4 |
  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8357640/ |
1000 Publikationsstatus
1000 Sprache der Publikation
1000 Abstract/Summary
  • Background!#!Patients with end-stage kidney disease are at high risk for the development of arrhythmias and sudden cardiac death (SCD). This has been especially attributed to large potassium shifts during hemodialysis (HD), and malignant arrhythmias are closely linked to dysfunction of the autonomic nervous system. Nevertheless, there is still a lack of methods for risk stratification in these patients.!##!Methods!#!In the present pilot study we investigated changes of the novel ECG-based biomarker periodic repolarization dynamics (PRD) mirroring the effect of efferent sympathetic nervous activity on the ventricular myocardium in 18 patients undergoing routine hemodialysis. High-resolution ECGs were recorded throughout the dialysis and PRD values were calculated out of 30 min intervals at the start and the end of dialysis.!##!Results!#!We detected a clear correlation between the intradialytic potassium shift and the increase in PRD levels (Spearman correlation coefficient R = 0.62, p = 0.006). Patients with a potassium shift > 1 mmol/l showed significantly increased levels of PRD at the end of dialysis when compared to patients with potassium shifts ≤ 1.0 mmol/l [delta PRD 2.82 (IQR 2.13) vs. - 2.08 (IQR 3.60), p = 0.006]. Spearman analysis showed no significant correlation between PRD changes and fluid removal (R = - 0.23, p = 0.36).!##!Conclusions!#!We provide evidence that large potassium shifts during HD enhance sympathetic activity-associated repolarization instability. This could facilitate the occurrence of malignant arrhythmias, and PRD measurements might serve as a non-invasive monitoring tool in HD patients in future.
1000 Sacherschließung
lokal Dialysis
lokal Heart [MeSH]
lokal Autonomic dysfunction
lokal Kidney Failure, Chronic/diagnosis [MeSH]
lokal Arrhythmia
lokal Potassium [MeSH]
lokal Periodic repolarization dynamics
lokal Humans [MeSH]
lokal Arrhythmias, Cardiac/diagnosis [MeSH]
lokal Pilot Projects [MeSH]
lokal Technical Note
lokal Kidney Failure, Chronic/therapy [MeSH]
lokal Arrhythmias, Cardiac/etiology [MeSH]
lokal Potassium shift
lokal Electrocardiography [MeSH]
lokal Renal Dialysis/adverse effects [MeSH]
1000 Liste der Beteiligten
  1. https://orcid.org/0000-0002-2546-5862|https://frl.publisso.de/adhoc/uri/U2Now7ZuZXJtYXJjaywgVWxm|https://frl.publisso.de/adhoc/uri/V2VubmVyLCBGZWxpeA==|https://frl.publisso.de/adhoc/uri/VG9lcGZlciwgTWFyY2VsbA==|https://frl.publisso.de/adhoc/uri/Uml6YXMsIEtvbnN0YW50aW5vcyBELg==|https://frl.publisso.de/adhoc/uri/QmF1ZXIsIEF4ZWw=|https://frl.publisso.de/adhoc/uri/QnJ1bm5lciwgU3RlZmFu|https://frl.publisso.de/adhoc/uri/SGFtbSwgV29sZmdhbmc=
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1000 Erstellt am 2023-11-18T16:26:07.569+0100
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1000 Zuletzt bearbeitet 2024-04-05T11:47:12.361+0200
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