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Kidney Week

Abstract: TH-PO0526

Corrected QT (QTc) Interval Prolongation, Dialysis Adequacy, Body Composition, and Coronary Artery Calcification in Patients on Hemodialysis

Session Information

Category: Dialysis

  • 801 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Mizuiri, Sonoo, Division of Nephrology, Ichiyokai Harada Hopital, Hiroshima, Hiroshima Prefecture, Japan
  • Nishizawa, Yoshiko, Division of Nephrology, Ichiyokai Harada Hopital, Hiroshima, Hiroshima Prefecture, Japan
  • Doi, Toshiki, Division of Nephrology, Ichiyokai Harada Hopital, Hiroshima, Hiroshima Prefecture, Japan
  • Morii, Kenichi, Division of Nephrology, Ichiyokai Harada Hopital, Hiroshima, Hiroshima Prefecture, Japan
  • Yamashita, Kazuomi, Division of Nephrology, Ichiyokai Harada Hopital, Hiroshima, Hiroshima Prefecture, Japan
  • Shigemoto, Kenichiro, Division of Nephrology, Ichiyokai Harada Hopital, Hiroshima, Hiroshima Prefecture, Japan
  • Masaki, Takao, Department of Nephrology, Hiroshima University Hospital, Hiroshima, Hiroshima Prefecture, Japan
Background

Corrected QT (QTc) interval prolongation which is an independent risk factor for sudden cardiac death and mortality is common in hemodialysis (HD) patients. We studied the causes and prognostic significance of QTc interval prolongation in maintenance HD patients.

Methods

Subjects were 338 HD patients. Baseline electrocardiograms were recorded before the dialysis session, and the QTc interval was estimated using Bazett’s formula. A prolonged QTc interval was defined as ≥450 ms for men and ≥460 ms for women. Clinical data, Agatston coronary artery calcium score (CACS), and post-dialysis body composition assessed using bioelectrical impedance analysis at baseline were collected. Logistic regression analyses for QTc interval prolongation, 3-year Kaplan–Meier survival curves, and Cox proportional hazards analyses for 3-year mortality were conducted.

Results

Median age, dialysis duration, and prevalence of diabetes ere 67 (56-74) years, 70 (33-141) months, and 39.1%, respectively. Kt/Vurea, predialysis β2-microglobulin, extracellular water/total body water (ECW/TBW), and CACS were significantly associated with QTc interval prolongation (P <0.05), whereas serum albumin and the geriatric nutritional risk index (GNRI) were not. Patients with QTc interval prolongation had significantly lower cumulative survival for 3-year all-cause and cardiovascular mortality than patients with a normal QTc interval (P <0.01). After adjusting for age, sex, dialysis duration, diabetes, serum albumin, C-reactive protein, and CACS, the QTc interval remained a significant predictor of 3-year all-cause and cardiovascular mortality (P <0.01).

Conclusion

Kt/Vurea, predialysis β2-microglobulin, ECW/TBW, and CACS showed significant associations with QTc interval prolongation in HD patients, whereas serum albumin and the GNRI did not. QTc interval prolongation was a significant predictor of 3-year all-cause and cardiovascular mortality.

Kaplan–Meier survival curves for 3-year mortality

Funding

  • Private Foundation Support

Digital Object Identifier (DOI)