Nephrol Dial Transplant (1992) 7: 318-322
© 1992 European Renal Association-European Dialysis and Transplant Association
research-article
Cardiac arrhythmias and electrolyte changes during haemodialysis
1Divisione di Nefrologia e Dialisi, Ospedale Niguarda-Ca'Granda Milan 2Servizio Dialisi, Ospedale di San Donato Milanese Italy
Correspondence and offprint requests to: Dr Giuseppe Rombolà, Divisione di Nefrologia e Dialisi, Ospedale Niguarda-Ca' Granda, Piazza Ospedale Maggiore 3, 20162 Milano, Italy
Cardiac arrhythmias are a frequent event in chronic haemodialysis patients, and their pathogenesis is still poorly understood. We evaluated plasma K+ (PK), intraerythrocytic K+ (EK) and acid-base changes during haemodialysis in six patients with frequent arrhythmias (A-pts), and in six (used as controls) nonarrhythmic dialysis patients (C-pts). PK decreased significantly (P < 0.01) during haemodialysis in both groups: A-pts (pre HD: 4.8±0.52 mM; 1st hour: 3.66±0.44; end HD: 3.17±0.38) and C-pts (4.75±0.80; 3.71±0.32 and 3.18±0.18 respectively) without any significant difference at any time between the two groups. Predialysis arterial pH and HCO3 were similar in A-pts (7.33±0.07 and 22.1±4.5 mM) and C-pts (7.29±0.04 and 19.7±2.6mM) but anapparently better correction of acidosis within the treatment was seen in A-pts (arterial pH 1st hour: 7.38±0.07; end HD: 7.39±0.07) than C-pts (1st hour: 7.31±0.02, P<0.05 versus A-pts; end HD: 7.33±0.03, P<0.05 versus A-pts). EK was significantly (P<0.01) greater at all times in C-pts (pre HD:90.6±15.7 mmol/1 RBC; 1st hour: 93.3±11.7; end HD 96.6±10.7) than A-pts (72.1±9.0; 77.2±3.7 and 79.3±8.4, respectively). We conclude that haemodialysis patients with arrhythmias have a decreased intraerythrocytic K content in comparison with other patients despite similar PK values; this finding might constitute a predisposing factor for arrhythmias.
Keywords: cardiac arrhythmias; potassium depletion; intraerythrocytic potassium; haemodialysis-associated electrolyte changes
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