SavedAdd your journal

Journals / Anatolian Journal of Emergency Medicine / 2021 / Cilt: 4 Sayı: 4

Investigation of the Presence of QT Dispersion and its Relationship with Electrolyte Imbalance in Patients with Acute Kidney Injury

Akut Renal Yetmezliği Olan Hastalarda QT Dispersiyon Varlığının ve Elektrolit Dengesizliği ile İlişkisinin Araştırılması

Egemen Noyın(Şehit Kamil State Hospital, Emergency Department, Gaziantep)0000-0002-2492-9629
Yeşim İşler(UNIVERSITY OF HEALTH SCIENCES, HEALTH RESEARCH CENTER, DEPARTMENT OF INTERNAL MEDICINE, DEPARTMENT OF ACADEMIC EMERGENCY MEDICINE)0000-0002-6389-5361
Halil Kaya(UNIVERSITY OF HEALTH SCIENCES, HEALTH RESEARCH CENTER, DEPARTMENT OF INTERNAL MEDICINE, DEPARTMENT OF ACADEMIC EMERGENCY MEDICINE)0000-0003-2005-6100
Melih Yüksel(UNIVERSITY OF HEALTH SCIENCES, HEALTH RESEARCH CENTER, DEPARTMENT OF INTERNAL MEDICINE, DEPARTMENT OF ACADEMIC EMERGENCY MEDICINE)0000-0002-0793-3693
Pages
132–137
Publication Date
2021-12-29
🏛️Bibliographic metadata and full text access for this article are provided via DergiPark.
DergiPark Record ↗
✨

AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

We think that QT dispersion in AKI follow-up may help the clinician predict possible complications and mortality.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:Aim: This study aims to investigate the relationship between QT dispersion and electrolyte imbalance in patients with acute kidney injury (AKI), and whether QT dispersion is associated with the severity of AKI.
📊
Key Findings & Data:Material and Methods: A total of 400 patients over the age of 18 presenting to a tertiary emergency department over a 3-month period were prospectively examined.
💡
Conclusion & Impact:We think that QT dispersion in AKI follow-up may help the clinician predict possible complications and mortality.
🔬Design:Araştırma Makalesi
📍Scope:Comprehensive Sample
⚙️Variables:Acil servis · akut renal yetmezlik · elektrolit imbalansı

Abstract

Aim: This study aims to investigate the relationship between QT dispersion and electrolyte imbalance in patients with acute kidney injury (AKI), and whether QT dispersion is associated with the severity of AKI. Material and Methods: A total of 400 patients over the age of 18 presenting to a tertiary emergency department over a 3-month period were prospectively examined. While 200 of the participants were diagnosed with AKI, 200 were in the control group. Presence of QT dispersion, potassium values, age and sex data, and blood urea nitrogen (BUN) /Creatinine (Cr) ratio parameters were examined and comparisons were made. Results: The mean age of patients diagnosed with AKI was 55.9±16.7 years, while it was 54.8±18.2 in the control group. QT dispersion was significantly higher in the AKI group (p<0.001). While the potassium value was 4.9±0.8 mEq/L in the AKI group with QT dispersion, it was 4.3±0.5 mEq/L in the control group. Potassium values were significantly higher in AKI patients with QT dispersion (p<0.001). When patients with AKI were compared in terms of QT dispersion, no significant difference was found between age, gender, electrolyte imbalances, and BUN/Cr ratios. Conclusion: Age and gender are not predictive parameters for QT dispersion in patients. Hyperkalemia is significantly higher in AKI patients with QT dispersion. High BUN/Cr ratio is not a predictive parameter for the presence of QT dispersion in patients with AKI. The frequency of QT dispersion is high in AKI patients. We think that QT dispersion in AKI follow-up may help the clinician predict possible complications and mortality.

Özet

Amaç: Bu çalışma, akut renal yetmezliği (ARY) olan hastalarda QT dispersiyonu ile elektrolit dengesizliği arasındaki ilişkiyi ve QT dispersiyonunun ARY şiddeti ile ilişkili olup olmadığını araştırmayı amaçlamaktadır. Gereç ve Yöntemler: Üçüncü basamak acil serviste 3 aylık bir süre içinde başvuran 18 yaş üstü toplam 400 hasta prospektif olarak incelendi. Katılımcıların 200'ü ARY tanısı alırken, 200'ü kontrol grubundaydı. QT dispersiyonu varlığı, potasyum değerleri, yaş ve cinsiyet verileri ve kan üre nitrojen (BUN)/Kreatinin(Cr) oranı parametreleri incelendi ve karşılaştırmalar yapıldı. Bulgular: ARY tanısı alan hastaların yaş ortalaması 55.9±16.7 yıl, kontrol grubunda ise 54,8±18,2 idi. ARY grubunda QT dispersiyonu anlamlı olarak daha yüksekti (p<0,001). Potasyum değeri QT dispersiyonlu ARY grubunda 4,9±0,8 mEq/L iken kontrol grubunda 4,3±0,5 mEq/L idi. QT dispersiyonu olan ARY hastalarında potasyum değerleri anlamlı olarak yüksekti (p<0,001). ARY'li hastalar QT dispersiyonu açısından karşılaştırıldığında yaş, cinsiyet, elektrolit dengesizlikleri ve BUN/Cr oranları arasında anlamlı fark bulunmadı. Sonuç: Yaş ve cinsiyet hastalarda QT dispersiyonu için prediktif parametreler değildir. QT dispersiyonu olan ARY hastalarında hiperkalemi anlamlı olarak daha yüksektir. Yüksek BUN/Cr oranı, ARY'li hastalarda QT dispersiyonunun varlığını öngören bir parametre değildir. ARY hastalarında QT dispersiyonunun sıklığı yüksektir. ARY takibinde QT dispersiyonunun klinisyene olası komplikasyonları ve mortaliteyi öngörmede yardımcı olabileceğini düşünüyoruz.

🔖

Cite This Article

Noyın, E., İşler, Y., Kaya, H., Yüksel, M. (2021). Investigation of the Presence of QT Dispersion and its Relationship with Electrolyte Imbalance in Patients with Acute Kidney Injury. Anatolian Journal of Emergency Medicine, Cilt: 4 Sayı: 4, 132–137. https://doi.org/10.54996/anatolianjem.982305

📄 Full Text PDF Viewer

📄

PDF görüntüleyici hazırlanıyor...

References (27)

  1. Li PK, Burdmann EA, Mehta RL. World kidney day steering committee 2013. Acute kidney injury: global health alert. Transplantation 201;95:653-7
  2. Rewa O, Bagshaw SM. Acute kidney injury-epidemiology, outcomes and economics. Nat Rev Nephrol 2014;10:19
  3. Patanè S, Marte F, Di Bella G, Currò A, Coglitore S. Int J Cardiol. 2008;12:130(2):71-3.
  4. Koc M, Toprak A, Ozener IC, et al. Nephron. 2002;91(2):250-4.
  5. Bagshaw SM, Bellomo R. Acute renal failure. Surgery 2007; 25: 391–8.
  6. Mehta RL, Pascual MT, Gruta CG, Zhuang S, Chertow GM. Refining predictive models in critically ill patients with acute renal failure. J Am Soc Nephrol 2002;13:1350-7
  7. Familoni OB, Alebiosu CO, Ayodele OE. Effects and outcome of haemodialysis on QT intervals and QT dispersion in patients with chronic kidney disease. Cardiovasc J S Afr. 2006;17(1):19-23.
  8. Toraman A, Colak H, Tekce H, Cam S, Kursat S. Relationship between angiotensin-converting enzyme gene polymorphism and QT dispersion in hemodialysis patients. Iran J Kidney Dis. 2017;11(3):217-22.
  9. Raizada V, Skipper B. Renin-angiotensin polymorphisms and corrected QT interval prolongation in end-stage renal disease. Kidney Int. 2005;68:1186-9
  10. Jeron A, Hengstenberg C, Engel S, et al. The D-allele of the ACE polymorphism is related to increased QT dispersion in 609 patients after myocardial infarction. Eur Heart J. 2001;22:663-8.
  11. Bernhardt WM, Wiesener MS, Weidemann A, et al. Involvement of hypoxia-inducible transcription factors in polycystic kidney disease. Am J Pathol. 2007;170:830-42.
  12. Kaya CT, Gurlek A, Altin T. The relationship between angiotensin converting enzyme gene I/D polymorphism and QT dispersion in patients with hypertrophic cardiomyopathy. Journal Renin Angiotensin Aldosterone Syst. 2010;11:192-7.
  13. Çalışkan Y, Yıldız A. Böbrek yetmezliği zemininde elektrolit bozuklukları. İstanbul Turkiye Klinikleri J Nephrol-Special Topics. 2010;3(1):44-9.
  14. Kollu K, Altintepe L, Duran C, Topal M, Ecirli S. The assessment of P-wave dispersion and myocardial repolarization parameters in patients with chronic kidney disease. Ren Fail. 2018;40(1):1-7
  15. Nitta K, Akiba T, Uchida K. Left ventricular hypertrophy is associated with arterial stiffnes and vascular calcification in hemodialysis patients. Hypertens Res. 2004;27:47–52.
  16. Unver S, Ozmen N, Aparci M. The influence of the amount of ultrafiltration in chronic hemodialysis on P wave dispersion. Renal Failure. 2007;29:207–12
  17. Monfared A, Ghods AJ. Improvement of maximum corrected QT and corrected QT dispersion in electrocardiography after kidney transplantation. Iran J Kidney Dis. 2008;2:95–8.
  18. Morin DP, Saad MN, Shams OF, et al. Relationships between the T-peak to T-end interval, ventricular tachyarhythmia, and death in left ventricular systolic dysfunction. Europace. 2012;14:1172–9.
  19. Ninkovic VM, Ninkovic SM, Miloradovic V, et al. Prevalence and risk factors for prolonged QT interval and QT dispersion in patients with type 2 diabetes. Acta Diabetol. 2016;53:737–44.
  20. Pun PH, Middleton JP. Sudden cardiac death in hemodialysis patients: a comprehensive care approach to reduce risk. Blood Purif. 2012; 33:183–9.
  21. Borisov VV, Shilov EM. Chronic renal failure. Urologiia. 2017;4:11-18.
  22. Stiefelhagen P. Therapy of chronic renal failure. Family practitioner and nephrologist hand in hand. MMW Fortschr Med. 2015;157(2):18-9.
  23. Cupisti A, Galetta F, Morelli E, et al. Effect of hemodialysis on the dispersion of the QTc interval. Nephron. 1998;78(4):429-32
  24. Koza Y. Acute kidney injury: current concepts and new insights. J Inj Violence Res. 2016;8(1):58-62
  25. Barbar SD, Binquet C, Monchi M, Bruyère R, Quenot JP. Impact on mortality of the timing of renal replacement therapy in patients with severe acute kidney injury in septic shock: the IDEAL-ICU study (initiation of dialysis early versus delayed in the intensive care unit): study protocol for a randomized controlled trial. Trials. 2014;7:15-27
  26. Manoeuvrier G, Bach-Ngohou K, Batard E, Masson D, Trewick D. Diagnostic performance of serum blood urea nitrogen to creatinine ratio for distinguishing prerenal from intrinsic acute kidney injury in the emergency department. BMC Nephrol. 2017;18(1):173
  27. Tariq M, Memon M, Jafferani A, et al. Massive fluid requirements and an unusual BUN/creatinine ratio for pre-renal failure in patients with cholera. PLoS One. 2009;26:4-10