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Abstract: FR-PO408

Hypocalcemia-Induced Bradycardia Is More Pronounced in Male Hemodialysis Patients

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis


  • Nairn, Deborah, Karlsruhe Institute of Technology, Karlsruhe, Germany
  • Ye, Xiaoling, Renal Research Institute, New York, New York, United States
  • Fuertinger, Doris H., Renal Research Institute, New York, New York, United States
  • Kotanko, Peter, Renal Research Institute, New York, New York, United States
  • Loewe, Axel, Karlsruhe Institute of Technology (KIT), Karlsruhe, Germany
  • Raimann, Jochen G., Renal Research Institute, New York, New York, United States

The risk of sudden cardiac death (SCD) is increased 14-fold in chronic hemodialysis (HD) patients compared to patients with normal kidney function suffering from cardiovascular diseases. This high rate is not explained by traditional cardiovascular risk factors. Recently, severe bradycardia has been implicated in SCD in HD patients. Mathematical modelling suggests an electrophysiological link between low serum calcium (Ca) levels and bradycardia. Therefore, we analyzed the correlation between heart rate (HR) and Ca as well as potassium (K).


Data were obtained from 18,141 individuals taken from the NHANES 2011-16 US cross-sectional survey and 741 chronic HD patients. To determine the correlation between HR (dependent variable), Ca and K, respectively, linear mixed effects models for HD patients included dialysis vintage as random effect. For NHANES subjects simple linear regression was employed.


In HD patients, a significant inverse correlation was found between HR and Ca. The effect was statistically significant only in males. The same effect with a similar factor of approximately 2 between the results for males and females was seen in the NHANES subjects. K had a significant inverse correlation with HR in both sexes.


Our results corroborate predictions of physiology-based mathematical models regarding the relation between HR and serum levels of K and Ca, respectively. In addition, we observed that the effect size of the HR-to-Ca relationship was larger in males. This unexpected finding warrants further investigation in other cohorts. If confirmed, the modulatory effects of sex on cardiac electrophysiology need to be explored.