ArticleJournal of nephrology2021
Large potassium shifts during dialysis enhance cardiac repolarization instability.
Article in Journal of nephrology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed, 16 citations in OpenAlex.
- Impact of energy drink versus coffee consumption on periodic repolarization dynamics: an interventional study.European journal of nutrition · 2022Trial
- Dynamic potassium variability (K-CV) as an independent predictor of mortality in maintenance hemodialysis.Renal failure · 2026Article
- Review
- Monitoring serum potassium concentration in patients with severe hyperkalemia: the role of bloodless artificial intelligence-enabled electrocardiography.Clinical kidney journal · 2025Article
- Hyperkalemia burden and treatment patterns in Chinese patients on hemodialysis: final analysis of a prospective multicenter cohort study (PRECEDE-K).Renal failure · 2024Article
- Brugada phenocopy with altered ST-segment elevation in pericardial diffuse large B-cell lymphoma and effusive-constrictive pericarditis: a case report.European heart journal. Case reports · 2023Article
- Hyperkalaemia prevalence and dialysis patterns in Chinese patients on haemodialysis: an interim analysis of a prospective cohort study (PRECEDE-K).BMC nephrology · 2023Observational
- Article
- Differences in ventricular wall composition may explain inter-patient variability in the ECG response to variations in serum potassium and calcium.Frontiers in physiology · 2023Article
- Monitoring of Serum Potassium and Calcium Levels in End-Stage Renal Disease Patients by ECG Depolarization Morphology Analysis.Sensors (Basel, Switzerland) · 2022Article
- Arrhythmias in Chronic Kidney Disease.European cardiology · 2022Review
- Periodic repolarization dynamics as predictor of risk for sudden cardiac death in chronic heart failure patients.Scientific reports · 2021Article
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Authors and funding
8 authors at 3 institutions in 3 countries.
Funding
Abstract
backgroundPatients with end-stage kidney disease are at high risk for the development of arrhythmias and sudden cardiac death (SCD). This has been especially attributed to large potassium shifts during hemodialysis (HD), and malignant arrhythmias are closely linked to dysfunction of the autonomic nervous system. Nevertheless, there is still a lack of methods for risk stratification in these patients.
methodsIn the present pilot study we investigated changes of the novel ECG-based biomarker periodic repolarization dynamics (PRD) mirroring the effect of efferent sympathetic nervous activity on the ventricular myocardium in 18 patients undergoing routine hemodialysis. High-resolution ECGs were recorded throughout the dialysis and PRD values were calculated out of 30 min intervals at the start and the end of dialysis.
resultsWe detected a clear correlation between the intradialytic potassium shift and the increase in PRD levels (Spearman correlation coefficient R = 0.62, p = 0.006). Patients with a potassium shift > 1 mmol/l showed significantly increased levels of PRD at the end of dialysis when compared to patients with potassium shifts ≤ 1.0 mmol/l [delta PRD 2.82 (IQR 2.13) vs. - 2.08 (IQR 3.60), p = 0.006]. Spearman analysis showed no significant correlation between PRD changes and fluid removal (R = - 0.23, p = 0.36).
conclusionsWe provide evidence that large potassium shifts during HD enhance sympathetic activity-associated repolarization instability. This could facilitate the occurrence of malignant arrhythmias, and PRD measurements might serve as a non-invasive monitoring tool in HD patients in future.
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