Korkmaz Ahmet, Yıldız Abdulkadir, Kundi Harun, Başyigit Funda, Gürsoy Havva Tuğba, Uçar Elalmış Özgül, Akyüz Abdurrahman, İleri Mehmet, Güray Ümit
Department of Cardiology, Ankara Numune Training and Research Hospital, Ankara, Turkey.
Turk Kardiyol Dern Ars. 2018 Jun;46(4):276-282. doi: 10.5543/tkda.2018.37666.
Due to rapid changes in volume and electrolyte concentration during hemodialysis (HD), some electrocardiographic (ECG) changes or arrhythmias can be seen. The aim of this study was to assess ECG QRS axis changes and other ECG parameters after HD in patients with end-stage renal disease (ESRD).
A total of 46 patients (65% male, mean age 52±15 years) with a sinus rhythm and without cardiovascular disease who were undergoing chronic HD treatment were included to the study. Blood samples, 12-lead electrocardiograms, and echocardiograms were recorded immediately before and at the end of an HD session. The QRS axis and other electrocardiographic, echocardiographic, electrolyte parameter, and volume changes were analyzed.
The serum urea, creatinine, potassium, and B-type natriuretic peptide concentrations significantly decreased after HD, and the serum calcium levels significantly increased after HD. Body weight significantly decreased after HD. There was no significant difference in the QRS duration, PR interval, P-wave axis, QRS axis, or QT and QTc interval following HD. Based on a comparison of variables according to the any QRS axis change after HD treatment, there was no significant difference in biochemical values, HD time, ultrafiltration volume, left ventricular ejection fraction, or other echocardiographic findings.
ESRD and HD are complex and dynamic processes, and the change in the QRS axis is rarely emphasized in these patients. In our study, there was no significant change in the QRS axis with HD in patients without cardiovascular disease.
由于血液透析（HD）过程中血容量和电解质浓度快速变化，可出现一些心电图（ECG）改变或心律失常。本研究旨在评估终末期肾病（ESRD）患者HD后ECG QRS轴变化及其他ECG参数。
本研究纳入46例接受慢性HD治疗、窦性心律且无心血管疾病的患者（男性占65%，平均年龄52±15岁）。在HD治疗前及结束时即刻采集血样、记录12导联心电图和超声心动图。分析QRS轴及其他心电图、超声心动图、电解质参数和容量变化。
HD后血清尿素、肌酐、钾和B型利钠肽浓度显著降低，血清钙水平显著升高。HD后体重显著下降。HD后QRS时限、PR间期、P波轴、QRS轴或QT及QTc间期无显著差异。根据HD治疗后QRS轴是否改变对变量进行比较，生化值、HD时间、超滤量、左心室射血分数或其他超声心动图结果无显著差异。
ESRD和HD是复杂的动态过程，这些患者中QRS轴的变化很少受到关注。在我们的研究中，无心血管疾病的患者HD后QRS轴无显著变化。
