Association Of Cardiac Arrhythmias And Residual Kidney Function In Hemodialysis Patients

Abstract

hhhhhChronici kidneyi diseasei (CKD) is a worldwide publici healthi problemi and cardiovasculari mortality is estimatedi to be at ileast 10- to 100-fold ihigher in patientsi with end istage renal idisease (ESRD) than in the age matchedi general ipopulation (Chan et al., 2011, Herzog et al., 2011).

hhhhhThe importance of residual kidney function (RKF) has been increasingly recognized as a significant determinant that influences the adequacy and frequency of dialysis, quality of life and mortality in end-stage renal disease (ESRD) patients.(Viral,2011). In addition to providing small solute clearance, RKF continues to maintain important metabolic, hemodynamic and endocrine functions, and plays a crucial role in maintaining the overall cardiovascular health, nutritional status, mineral metabolism balance and well-being of patients undergoing dialysis .(Thomas J,2011). Many clinical guidelines have clearly recommended that striving to slow down the RKF loss should be the primary objective of dialysis treatment.(Bargman JM,2006). hhhhhResidual kidney function contributes significantly to the overall health and well-being of dialysis patients. It doesn’t only provide small solute clearance but also plays an important role in maintaining fluid balance phosphorus control, and removal of middle molecular uremic toxins, and shows strong inverse relationships with valvular calcification and cardiac hypertrophy in dialysis patients.Decline of residual renal function also contributes significantly to anemia, inflammation, and malnutrition in patients on dialysis. Seriously, the loss of residual renal function, is a powerful predictor of mortality.(K-N Loi,2006). hhhhhRiski factorsi for increasedi arrhythmogenicityy includee compromisedi myocardiumi (due to either underlying CADi, idecreased icoronary reservei bloodi flowi, or the iconsequences of iuremia on myocardiall functioni and istructure), increasedi QTc intervall or dispersioni, electrolyteeiabnormalities, intradialyticc hypotensioni, concomitantt presencei of LVH (ialmost present in 80%of patients on dialysis),and autonomic dysfunction (with or without diabetes). Dialysiss patientss haveeifrequent ielectrolyte abnormalitiess such as ifluctuating llevels of potassium, iionized calciumi, magnesiumm, and other idivalent ions.Due to thei intermittenti nature of the idialysis iprocedure, patientss on HD ihave wide ifluctuations in volume istatus, andi potassium andi bicarbonate levelsd, in betweeni dialysis treatments. (GoldenbergI,2008).

The aim of this work is to assess possible assosciation between residual kidney function and cardiac arrhythmia in hemodialysis patients.

hhhhhSixty patients with end stage renal disease who were undergoing maintainace HD at Dar elshfaa hemodialysis unit enrolled in this crosssectional study.Thirty patients of them had RKF(groupI) ,but the another 30 patients didn't have RKF(group II).