Hemodialysis-Associated Cardiac Arrhythmias: A Lower Risk with Bicarbonate?

Fantuzzi, S.; Caico, Salvatore Ivan; Amatruda, O.; Cervini, Paolo; Abu-Turky, H.; Baratelli, L.; Donati, D; Gastaldi, L

doi:10.1159/000186414

Cited by 28 publications

(15 citation statements)

References 11 publications

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“…Historically, single-patient proportionating systems for technical reason used acetate as the buffer, but with the availability of the new generation of dialysis machines, coupled with the side effects associated with acetate, it is rarely used today [30,31] . The availability of a three-stream mixing for bicarbonate-buffered dialysis fl uid has meant that bicarbonate has become the buffer of choice.…”

Section: Dialysis Fluid Buffermentioning

confidence: 99%

The Importance of Water Quality and Haemodialysis Fluid Composition

Hoenich¹,

Ronco²,

Levin³

2005

Blood Purif

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Treatment of renal failure by haemodialysis uses dialysis fluid to facilitate the normalization of electrolyte and acid base abnormalities and the removal of low molecular weight uraemic compounds present in the plasma such as urea. The dialysis fluid is a continuously produced blend of treated tap water and a concentrated solution containing electrolytes, buffer, and glucose. The water used originates as drinking water but undergoes additional treatment. Recent surveys have indicated that the chemical and microbiological content of such water frequently fails to meet the requirements of established standards, and its bacterial content arising from the presence of a biofilm in the water distribution network or the hydraulic circuit of the dialysis machine is a contributory factor to the chronic inflammatory state in patients undergoing regular dialysis. The composition of the dialysis fluid plays an important role in the modulation of complications associated with end-stage renal disease, as well as those associated with the treatment itself. The avoidance of complications arising from water contaminants requires a constant and vigorous attention to water quality, whilst with the composition of electrolytes and buffer there is a trend towards greater individualization to provide a high degree of treatment tolerance.

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Section: Dialysis Fluid Buffermentioning

confidence: 99%

The Importance of Water Quality and Haemodialysis Fluid Composition

Hoenich¹,

Ronco²,

Levin³

2005

Blood Purif

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“…In a recent study, arrhythmia, valvular disease, cardiomyopathy and cardiac arrest have been reported to be the most common cardiac events in paediatric dialysis patients 2 . Ventricular arrhythmias occur commonly in haemodialysis patients, and are associated with increased risk of sudden cardiac death 3–10 …”

Section: Introductionmentioning

confidence: 99%

Impact of haemodialysis on QTc dispersion in children

et al. 2005

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“…Predialytic and postdialytic QTc dispersion measurements were 50.8±12.0 and 52.2± 13.3 msec, respectively, and these are not statistically significant. Predialytic and postdialytic QTc (15)(16)(17), and rapid correction of metabolic acidosis (18) that can influence the occurrence of arrhythmogenesis in ESRD patients.…”

Section: Discussionmentioning

confidence: 99%

The Comparison of Four Different Dialysates on QT Dispersion and Arrhythmias in Hemodialysis Patients

Türkmen¹,

Mil²,

Solak³

et al. 2012

Turk Neph Dial Transpl

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OBJECTIVES: Sudden cardiac death (SCD) is common in patients with end-stage renal disease receiving hemodialysis. SCD may be caused by electrolyte imbalance or malignant arrhythmias in hemodialysis patients. We aimed to evaluate the effects of four different dialysates on QT dispersion and arrhythmia. MATERIAl and METHODS:Twenty-one patients receiving hemodialysis were enrolled. Four different dialysates were used and twelve-lead ECG measurements were recorded to determine QTc and QTc dispersion. Holter ECG was performed to assess arrhythmia. RESUlTS:In group 1 (1.0 K +, 1.5 Ca++), predialytic and postdialytic QTc dispersion measurements were 52.3±11.7 and 59.2± 13.1 msec respectively and this is statistically significant (p=0.007). In group 2 (2.0 K +, 1.5 Ca++), group 3 (1.0K +, 1.75Ca++), and in group 4 (2.0 K +, 1.75Ca++), QTc dispersion measurements were 53.5±14.4 and 53.2± 15.0 msec, 53.5±14.4 and 53.2±15.0 msec, 50.8±12.0 and 52.2±13.3 msec, 51.3±12.2 and 52.1±12.3 msec, respectively, and these were not statistically significant. CONClUSION:In group 1, patients had higher QTc dispersion. There was no statistically significant difference regarding QTc dispersion among the four groups. We also could not find an increased rate of arrhythmias in the groups. These results suggest that there may be other causative risk factors that can affect QT dispersion and arrhythmias in hemodialysis patients.

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Hemodialysis-Associated Cardiac Arrhythmias: A Lower Risk with Bicarbonate?

Cited by 28 publications

References 11 publications

The Importance of Water Quality and Haemodialysis Fluid Composition

The Importance of Water Quality and Haemodialysis Fluid Composition

Impact of haemodialysis on QTc dispersion in children

The Comparison of Four Different Dialysates on QT Dispersion and Arrhythmias in Hemodialysis Patients

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