Article (Scientific journals)
A simple modification of dialysate potassium: its impact on plasma potassium concentrations and the electrocardiogram
DELANAYE, Pierre; KRZESINSKI, François; DUBOIS, Bernard et al.
2021In Clinical Kidney Journal, 14 (1), p. 390-397
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Keywords :
arrhythmia; haemodialysis; potassium
Abstract :
[en] Background. Sudden death is frequent in haemodialysis (HD) patients. Both hyperkalaemia and change of plasma potassium(K) concentrations induced by HD could explain this. The impact of increasing dialysate K by 1 mEq/L on plasma K concentrations and electrocardiogram(ECG) results before and after HD sessions was studied. Methods. Patients with pre-dialysis K>5.5 mEq/L were excluded. ECG and K measurements were obtained before and after the first session of the week for 2 weeks. Then, K in the dialysate was increased (from 1 or 3 to 2 or 4 mEq/L, respectively). Blood and ECG measurements were repeated after 2 weeks of this change. Results. Twenty-seven prevalent HD patients were included. As expected, a significant decrease in K concentrations was observed after the dialysis session, but this decrease was significantly lower after the switch to an increased dialysate K. The pre-dialysis K concentrations were not different after changing, but post-dialysis K concentrations were higher after switching (P<0.0001), with a lower incidence of post-dialysis hypokalaemia. Regarding ECG, before switching, the QT interval (QT) dispersion increased during the session, whereas no difference was observed after switching. One week after switching, post-dialysis QT dispersion [38 (34–42) ms] was lower than post-dialysis QT dispersion 2 weeks and 1 week before switching [42 (38–57) ms, P¼0.0004; and 40 (35–50) ms, P¼0.0002]. Conclusions. A simple increase of 1 mEq/L of K in the dialysate is associated with a lower risk of hypokalaemia and a lower QT dispersion after the dialysis session. Further study is needed to determine if such a strategy is associated with a lower risk of sudden death.
Disciplines :
Cardiovascular & respiratory systems
Author, co-author :
DELANAYE, Pierre  ;  Centre Hospitalier Universitaire de Liège - CHU > Département de médecine interne > Service de néphrologie
KRZESINSKI, François ;  Centre Hospitalier Universitaire de Liège - CHU > Département de médecine interne > Service de cardiologie
DUBOIS, Bernard ;  Centre Hospitalier Universitaire de Liège - CHU > Département de médecine interne > Service de néphrologie
DELCOUR, Alexandre ;  Centre Hospitalier Universitaire de Liège - CHU > Département de médecine interne > Rythmologie & Pacemaker
Robinet, Sébastien ;  Université de Liège - ULiège > Département des sciences cliniques > Département des sciences cliniques
PIETTE, Caroline ;  Centre Hospitalier Universitaire de Liège - CHU > Département de médecine interne > Service de cardiologie
KRZESINSKI, Jean-Marie ;  Centre Hospitalier Universitaire de Liège - CHU > Département de médecine interne > Service de néphrologie
LANCELLOTTI, Patrizio  ;  Centre Hospitalier Universitaire de Liège - CHU > Département de médecine interne > Service de cardiologie
Language :
English
Title :
A simple modification of dialysate potassium: its impact on plasma potassium concentrations and the electrocardiogram
Publication date :
2021
Journal title :
Clinical Kidney Journal
ISSN :
2048-8505
eISSN :
2048-8513
Publisher :
Oxford University Press, United Kingdom
Volume :
14
Issue :
1
Pages :
390-397
Peer reviewed :
Peer Reviewed verified by ORBi
Available on ORBi :
since 12 November 2020

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