Cardiac Arrhythmias on Hemodialysis in Chronic Renal Failure Patients

Abstract

A high incidence (40%) of cardiac arrhythmias was found in patients while on dialysis. This incidence was significantly higher than on nondialysis days. A comparison study of patients with significant cardiac arrhythmia and patients with cardiac arrhythmia was made. There was no difference in the echocardiogram, total body potassium, plasma renin activity, aldosterone, catecholamines, serum sodium, potassium and calcium between the two groups. Significant alkalinization occurred in all patients at the end of dialysis. Blood levels of total PTH and C peptide were higher in the arrhythmic patients versus the nonarrhythmic patients. No explanation was found as to why patients developed arrhythmias or what differentiated the two groups.

Ventricular Tachyarrhythmia Treated by Parathyroidectomy in a Chronically Hemodialyzed Patient

“…Ramirez et al [2] also reported supportive data o f our thesis of a significantly higher concentration of c-PTH in patients with cardiac arrhythmias than in patients with out arrhythmias, suggesting that PTH might induce ar rhythmias in uremic patients. It can also be argued that calcium is an arrhythmogenic agent [3], especially in cases of hypercalcemia with digitalis administration where it is thought that ventricular arrhythmias tend to be easily provoked [4], In the present case, however, even after parathyroidectomy, serum concentrations of cal cium were well maintained at values greater than 7.5 mg/dl by means of intravenous infusion of CaC U and the oral administration o f la-(O H )D ,.…”

Hemodialysis-Induced Left Ventricular Dysfunction Is Associated with an Increase in Ventricular Arrhythmias

“…ectopy in the form of PVCs and CVAs is increased during HD, which is consistent with previously published evidence. [21,22] More significantly, we have demonstrated a significantly higher frequency of PVCs during HD in those patients who develop dialysis-induced acute cardiac injury (in the form of RWMAs).…”

Ventricular Arrhythmias and Sudden Cardiac Death in End-Stage Renal Disease Patients on Chronic Hemodialysis

“…PTH has been shown to cause deterioration of cardiac function [7, 101]and so-called uremic cardiomyopathy [12, 102]. Some authors reported that the PTH concentration was significantly higher in patients with cardiac arrhythmias than in those without arrhythmias and suggested that PTH might be an arrhythmogenic agent in uremic patients [89, 103]. Other factors implicated in ventricular arrhythmias are a decrease in the extracellular volume, a fast correction of metabolic acidosis, an increase in free fatty acid levels, differences between serum and intracellular potassium concentrations, and an impaired magnesium metabolism.…”