The Effect of the Type of Hemodialysis Buffer on the QTc Interval in Patients on Chronic Hemodialysis
Background: Identifying the sources of variation in QTc measurementsis important for preventing arrhythmias during and afterhemodialysis. The present study was designed to determine thecorrelation between the type of hemodialysis buffer and thechanges in QTc interval in patients on chronic hemodialy...
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Shiraz University of Medical Sciences
2009-03-01
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doaj-0e9d437fa6ab470e9dcc3aebd8042a2b2020-11-25T01:51:49ZengShiraz University of Medical SciencesIranian Journal of Medical Sciences0253-07161735-36882009-03-013412935The Effect of the Type of Hemodialysis Buffer on the QTc Interval in Patients on Chronic HemodialysisReza HekmatAbddollah BahramiMostafa AhmadiHossein NazariBackground: Identifying the sources of variation in QTc measurementsis important for preventing arrhythmias during and afterhemodialysis. The present study was designed to determine thecorrelation between the type of hemodialysis buffer and thechanges in QTc interval in patients on chronic hemodialysis.Methods: Fifty-nine patients on chronic hemodialysis whoreferred in winter 2007 to hemodialysis centers of Ghaem andHashemi Nejad hospitals, in Mashhad, Iran, were divided intotwo groups according to their last dialysate buffer: acetate orbicarbonate. Electrocardiography, arterial blood gas parameters,serum K+, Na+, ionized calcium, and albumin levels weremeasured prior to and after hemodialysis in all patients.Results: All arterial blood gas parameters and serum electrolytesconcentrations were increased except K+ levels that weresignificantly decreased with hemodialysis. PCO2 and QTc intervalswere slightly increased in all patients, however thisincrease was not statistically significant. We found that thetype of dialysate affected the QTc interval, HCO3, base excess,base excess of extra cellular fluid, and base bufferchanges with no effect on ionized calcium, pH, PCO2, andserum albumin concentration. QTc interval was prolonged byusing bicarbonate and shortened by using acetate dialysatebuffer. We found no correlation between the variations of QTcinterval and serum electrolytes or arterial blood gas parametersin either group.Conclusion: Bicarbonate buffer use in hemodialysis prolongedQTc interval and acetate buffer shortened it. This effectis independent of serum electrolytes and pH changes duringhemodialysis. The effect of bicarbonate buffer is probablydue to more tolerability of ultra filtration, more effectiveedema reduction and augmented body electro-conductivity.http://ijms.sums.ac.ir/files/PDFfiles/34_1_04-Dr_%20Hekmat.pdf1358141926.pdfChronichemodialysisdialysate buffer |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Reza Hekmat Abddollah Bahrami Mostafa Ahmadi Hossein Nazari |
spellingShingle |
Reza Hekmat Abddollah Bahrami Mostafa Ahmadi Hossein Nazari The Effect of the Type of Hemodialysis Buffer on the QTc Interval in Patients on Chronic Hemodialysis Iranian Journal of Medical Sciences Chronic hemodialysis dialysate buffer |
author_facet |
Reza Hekmat Abddollah Bahrami Mostafa Ahmadi Hossein Nazari |
author_sort |
Reza Hekmat |
title |
The Effect of the Type of Hemodialysis Buffer on the QTc Interval in Patients on Chronic Hemodialysis |
title_short |
The Effect of the Type of Hemodialysis Buffer on the QTc Interval in Patients on Chronic Hemodialysis |
title_full |
The Effect of the Type of Hemodialysis Buffer on the QTc Interval in Patients on Chronic Hemodialysis |
title_fullStr |
The Effect of the Type of Hemodialysis Buffer on the QTc Interval in Patients on Chronic Hemodialysis |
title_full_unstemmed |
The Effect of the Type of Hemodialysis Buffer on the QTc Interval in Patients on Chronic Hemodialysis |
title_sort |
effect of the type of hemodialysis buffer on the qtc interval in patients on chronic hemodialysis |
publisher |
Shiraz University of Medical Sciences |
series |
Iranian Journal of Medical Sciences |
issn |
0253-0716 1735-3688 |
publishDate |
2009-03-01 |
description |
Background: Identifying the sources of variation in QTc measurementsis important for preventing arrhythmias during and afterhemodialysis. The present study was designed to determine thecorrelation between the type of hemodialysis buffer and thechanges in QTc interval in patients on chronic hemodialysis.Methods: Fifty-nine patients on chronic hemodialysis whoreferred in winter 2007 to hemodialysis centers of Ghaem andHashemi Nejad hospitals, in Mashhad, Iran, were divided intotwo groups according to their last dialysate buffer: acetate orbicarbonate. Electrocardiography, arterial blood gas parameters,serum K+, Na+, ionized calcium, and albumin levels weremeasured prior to and after hemodialysis in all patients.Results: All arterial blood gas parameters and serum electrolytesconcentrations were increased except K+ levels that weresignificantly decreased with hemodialysis. PCO2 and QTc intervalswere slightly increased in all patients, however thisincrease was not statistically significant. We found that thetype of dialysate affected the QTc interval, HCO3, base excess,base excess of extra cellular fluid, and base bufferchanges with no effect on ionized calcium, pH, PCO2, andserum albumin concentration. QTc interval was prolonged byusing bicarbonate and shortened by using acetate dialysatebuffer. We found no correlation between the variations of QTcinterval and serum electrolytes or arterial blood gas parametersin either group.Conclusion: Bicarbonate buffer use in hemodialysis prolongedQTc interval and acetate buffer shortened it. This effectis independent of serum electrolytes and pH changes duringhemodialysis. The effect of bicarbonate buffer is probablydue to more tolerability of ultra filtration, more effectiveedema reduction and augmented body electro-conductivity. |
topic |
Chronic hemodialysis dialysate buffer |
url |
http://ijms.sums.ac.ir/files/PDFfiles/34_1_04-Dr_%20Hekmat.pdf1358141926.pdf |
work_keys_str_mv |
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