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The ECG Manifestation of Hyperkalemia in End Stage Renal Disease Patients on Maintenance Haemodilysis

Author: Sahban Al- Malah
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2008 Volume: 7 Issue: 3 Pages: 245-248
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND:It is speculated that usual electrocardiographic manifestations of hyperkalemia are less pronounced in patients with end stage renal disease ((ESRD)) than in those with normal renal function, those patients usually have tolerance for hyperkalemia and the usual cardiac and neuromuscular sequalaes are less evident possibly due in part to fluctuation in serum calicium concentraton .METHODS:We studied 70 consecutivly selected stable haemodialysis patients to determine the prevalence of ECG changes of hyperkalemia, predialysis serum potassium concentration and pther electrolytes were measured and smiltaneous 12- lead electrocardiogram obtained.RESULTS:The 70 study subjects ((35 males, 35 females )) age 45.5_+10.6((range 24-60)) mean duration of ESRD was 22_+20 months((range4-60 )).-Mean predialysis serum potassium concentration was 4.7 _+0,9mEq/L(range 3.5-7.1). – Mean precordil leads T wave amplitude for entire group was 5.2_+4.4mm.- Mean T wave to R wave ratio was 0.4 _+ 0.1 .- Mean serum calcium concentration was 9.0_+0.61mq/dl(range 7.5-11.8).-No study subject had evident arrhythmia.-There was no significant difference in T wave amplitude (p=o.11)or T wave to R wave (p=0.12) between quartiles of serum potassium concentration.-Total serum calcium concentration had inverse relation with T wave amplitude ( p=0.007).CONCLUSION:Haemodialysis patients with hyperkalemia may not exhibit the electrocardiographic changes of hyperkalemia, thus the absence of ECG changes in hyperkalemic haemodialysis patients should interpreted with caution

Keywords

ECG --- ESRD --- haemodilysis --- hyperkalemia.

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