JHSM
Journal of Health Sciences and Medicine

Journal of Health Sciences and Medicine (JHSM) is an unbiased, peer-reviewed, and open access international medical journal. The Journal publishes interesting clinical and experimental research conducted in all fields of medicine, interesting case reports, and clinical images, invited reviews, editorials, letters, comments, and related knowledge.

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Original Article
Comparison of pathological electrocardiographic changes between long-term kidney transplant recipients and hemodialysis patients
Abstract
Aims: We aimed to reveal electrocardiographic changes in kidney transplant recipients (KTRs) compared with hemodialysis patients.
Methods: We included 70 KTRs who had underwent a kidney transplantation for more than one year and 84 patients who had been on hemodialysis for more than one year. We recorded age, sex, body-mass index (BMI) (kg/m2), primary disease (makes chronic kidney disease) and duration of hemodialysis treatment. Standard measurements such as heart rate (HR), P wave, PR interval, P axis, QRS complex, QRS axis, T axis, QT interval and QTc interval were performed for all electrocardiography (ECG).
Results: KTRs were younger than the hemodialysis patients group (HPG) (31.5 vs. 54.5, p<0.001). The female gender was more common in the HPG (54.8% vs. 28.6%, p=0.001). Diabetes mellitus (DM) and hypertension (HT) were more common in the HPG (21.4% vs. 7.1% and 47.6% vs. 15.7% respectively, p<0.001). There was no statistically significant difference between KTRs and HPG in terms of heart rate, P axis, P-wave, QRS axis, QRS complex, RR interval, while T axis was higher in HPG (65o vs. 40.5o, p=0.001), PR interval was longer in HPG (152 msec vs 144 msec, p=0.020), QT interval was longer in HPG (385 msec vs 360 msec, p<0.001), QTc was longer in HPG (463 msec vs 415.5 msec, p<0.001).
Conclusion: In the long term after kidney transplantation, improvement of ECG pathologies such as prolonged QT and abnormal T axis seen in HPG may be the result of an improved uremic milieu and reduced inflammation in KTRs.

Keywords : Kidney transplant recipient, hemodialysis, prolonged QT

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1. Johansen KL, Chertow GM, Gilbertson DT, et al. US Renal Data System 2021 Annual Data Report: Epidemiology of Kidney Disease in the United States. <em>Am J Kidney Dis.</em> 2022;79(4 Suppl 1):A8-A12.
2. Ortiz A, Covic A, Fliser D, et al. Epidemiology, contributors to, and clinical trials of mortality risk in chronic kidney failure. <em>Lancet</em>. 2014;383(9931):1831-1843.
3. Genovesi S, Boriani G, Covic A, et al. EUDIAL working group of ERA-EDTA. Sudden cardiac death in dialysis patients: different causes and management strategies. <em>Nephrol Dial Transplant.</em> 2021;36(3):396-405.
4. Saran R, Robinson B, Abbott KC, et al. US Renal Data System 2018 Annual Data Report: Epidemiology of Kidney Disease in the United States. <em>Am J Kidney Dis</em>. 2019;73(3 Suppl 1):A7-A8.
5. Wilson GJ, Van K, O&rsquo;Lone E, et al. Range and consistency of cardiovascular outcomes reported by clinical trials in kidney transplant recipients: a systematic review. <em>Transplant Direct.</em> 2022;9(1):e1398.
6. Di Iorio B, Bellasi A. QT interval in CKD and haemodialysis patients. <em>Clin Kidney J.</em> 2013;6(2):137-1343.
7. Goldberger AL, Goldberger ZD, Shvilkin A. Goldberger&rsquo;s Clinical Electrocardiography a Simplified Approach 8<sup>th</sup> ed. Elsevier Saunders, 2013.
8. Salles GF, Xavier SS, Sousa AS, Hasslocher-Moreno A, Cardoso CR. T-wave axis deviation as an independent predictor of mortality in chronic Chagas&rsquo; disease. <em>Am J Cardiol.</em> 2004;93(9): 1136-1140.
9. Jankowski J, Floege J, Fliser D, B&ouml;hm M, Marx N. Cardiovascular disease in chronic kidney disease: pathophysiological insights and therapeutic options. <em>Circulation.</em> 2021;143(11):1157-1172.
10. Boriani G, Savelieva I, Dan GA, et al. Chronic kidney disease in patients with cardiac rhythm disturbances or implantable electrical devices: clinical significance and implications for decision making-a position paper of the European Heart Rhythm Association endorsed by the Heart Rhythm Society and the Asia Pacific Heart Rhythm Society. <em>Europace</em>. 2015;17(8):1169-1196.
11. Xu C, Tsihlis G, Chau K, Trinh K, Rogers NM, Julovi SM. Novel perspectives in chronic kidney disease-specific cardiovascular disease. <em>Int J Mol Sci.</em> 2024;25(5):2658.
12. Akcay M, Yıldırım U. Effect of dialysis and transplantation on myocardial repolarization parameters and P-wave dispersion in chronic kidney disease. <em>J Arrhythm.</em> 2021;37(2):348-355.
13. Genovesi S, Rossi E, Nava M, et al. A case series of chronic haemodialysis patients: mortality, sudden death, and QT interval. <em>Europace.</em> 2013;15(7):1025-1033.
14. Sherif KA, Abo-Salem E, Panikkath R, et al. Cardiac repolarization abnormalities among patients with various stages of chronic kidney disease. <em>Clin Cardiol.</em> 2014;37(7):417-421.
15. Oktavia D, Nasution SA, Setiati S. The clinical factors&rsquo;prediction of increased intradialytic QT dispersion on the electrocardiograms of chronic hemodialysis patients. <em>Saudi J Kidney Dis Transpl.</em> 2013;24(2):274-280.
16. Hage FG, de Mattos AM, Khamash H, et al. QT prolongation is an independent predictor of mortality in end-stage renal disease. <em>Clin Cardiol.</em> 2010;33(6):361-366.
17. Beaubien ER, Pylypchuk GB, Akhtar J, et al. Value of corrected QT interval dispersion in identifying patients initiating dialysis at increased risk of total and cardiovascular mortality. <em>Am J Kidney Dis.</em> 2002;39(4):834-842.
18. Monfared A, Ghods AJ. Improvement of maximum corrected QT and corrected QT dispersion in electrocardiography after kidney transplantation. <em>Iran J Kidney Dis.</em> 2008;2(2):95-98.
19. Monfared A, Atrkar Roshan Z, Salari A, et al. QT intervals in patients receiving a renal transplant. <em>Exp Clin Transplant.</em> 2012; 10(2):105-109.
20. Durak MI, Algul Durak B. The comparison of QTc dispersion between renal transplant recipients and healthy individuals. <em>Cureus.</em> 2022;14(12):e32458.
21. Liu P, Wang L, Han D, Sun C, Xue X, Li G. Acquired long QT syndrome in chronic kidney disease patients. <em>Ren Fail.</em> 2020; 42(1):54-65.
22. Robison LB, Brady WJ, Robison RA, Charlton N. QT interval prolongation and the risk of malignant ventricular dysrhythmia and/or cardiac arrest: Systematic search and narrative review of risk related to the magnitude of QT interval length. <em>Am J Emerg Med.</em> 2021;49:40-47.
23. Scherer ML, Aspelund T, Sigurdsson S, et al. Abnormal T-wave axis is associated with coronary artery calcification in older adults. <em>Scand Cardiovasc J.</em> 2009;43(4):240-248.
Article available in :
Volume 7, Issue 5, 2024
Page : 513-517
https://doi.org/10.32322/jhsm.1519695
Article Information
Received : 20 Tem 2024
Accepted : 16 Ağu 2024
Published : 27 Eyl 2024
Corresponding Author :

Süleyman Akkaya: Department of Cardiology, Diyarbakır Gazi Yaşargil Training and Research Hospital, University of Health Sciences, Diyarbakır, Turkiye

[email protected]
Citation : Akkaya S, Çakmak Ü. Comparison of pathological electrocardiographic changes between long-term kidney transplant recipients and hemodialysis patients. J Health Sci Med. 2024;7(5):513-517.

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