Umapathi Krishna Kishore, Lee Sunah, Jacobson Jessica, Jandeska Sara, Nguyen Hoang H
Pediatrics, Rush University Medical Center, Chicago, USA.
Pediatrics, Childrens Hospital of Los Angeles, Los Angeles, USA.
Cureus. 2020 Jul 11;12(7):e9132. doi: 10.7759/cureus.9132.
Hemodialysis affects myocardial depolarization and repolarization notably lengthening the QT interval. Prolonged QT, in turn, has been a reliable surrogate for higher risk of potentially lethal ventricular arrhythmias. We present an adolescent girl with end-stage kidney disease who consistently developed prolonged QT following hemodialysis sessions. Interestingly, her QT intervals were inversely correlated with her serum magnesium levels. Magnesium supplementation appeared to help reduce the QT prolongation after hemodialysis. Our case shows the potential utility of magnesium as a cardioprotective agent in hemodialysis patients. We recommend that patients undergoing hemodialysis receive frequent electrocardiograms and electrolytes monitoring for tailored electrolytes management to reduce the risk of developing potentially lethal cardiac arrhythmias.
血液透析显著影响心肌去极化和复极化,使QT间期明显延长。而QT间期延长反过来一直是潜在致命性室性心律失常风险较高的可靠替代指标。我们报告一名患有终末期肾病的青春期女孩,她在血液透析后持续出现QT间期延长。有趣的是,她的QT间期与血清镁水平呈负相关。补充镁似乎有助于减少血液透析后的QT间期延长。我们的病例显示了镁作为血液透析患者心脏保护剂的潜在作用。我们建议接受血液透析的患者应频繁进行心电图和电解质监测,以便进行针对性的电解质管理,以降低发生潜在致命性心律失常的风险。