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Ventricular Arrhythmias in Hemodialysis Patients: A Study of Incidence and Contributory Factors

  • Ken-ichi Kimura
  • Kaoru Tabei
  • Toshio Nakayama
  • Yasushi Asano
  • Saichi Hosoda

Abstract

One hundred patients undergoing maintenance hemodialysis for chronic renal failure were evaluated by Holter ECG monitoring for a 72-hour period from the day of hemodialysis therapy. Eighteen patients (the frequent group) who had more than 700 premature ventricular contractions (PVCs) per day were found among these 100 patients. In those eighteen, the PVCs were recorded frequently during and for 4 hours after hemodialysis. The values of the serum calcium concentration times those of phosphorus, which are thought to be an index of parathyroid function, were significantly higher in the frequent group than in patients without PVCs (the no arrhythmia group) or in those with fewer PVCs (less than 700 beats per day; sporadic group). Also, in the frequent group, the percent fractional shortening of the left ventricle, as measured by 2-dimensional echocardiography, was significantly lower than those in the no arrhythmia and sporadic groups. From these results, we conclude that the pathogenesis of the PVCs in chronic renal failure resulted partially from impaired cardiac performance and accelerated parathyroid function.

Keywords

Chronic Renal Failure Ventricular Arrhythmia Hemodialysis Patient Holter Monitoring Uremic Patient 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    S.G. Massry, D.A. Goldstein: The search for uremic toxin(s)‘X’ ‘X’=PTH. Clin. Nephrol. 11: 181–189 (1979).Google Scholar
  2. 2.
    U. Gafter, A. Battler, M. Eldar, D. Zevin, H.N. Neufeld, J. Levi: Effect of hyperparathyroidism on cardiac function in patients with end-stage renal disease. Nephron 41: 30–33 (1985).PubMedCrossRefGoogle Scholar
  3. 3.
    J. Collins, S.G. Massry, V.M. Camperse: Parathyroid hormone and the altered vascular response to norepinephrine in uremia. Am. J. Nephrol. 5: 110–113 (1985).PubMedCrossRefGoogle Scholar
  4. 4.
    R.J.S. McGonigle, M.B. Fowler, A.B. Timmis, M.J. Weston, V. Parsons: Uremic cardiomyopathy: Potential role of vitamin D and parathyroid hormone. Nephron 36: 94–100 (1984).PubMedCrossRefGoogle Scholar
  5. 5.
    G. Ramirez, CD. Brueggemeyer, I.L. Newton: Cardiac arrhythmias on hemodialysis in chronic renal failure patients. Nephron 36: 212–218 (1984).PubMedCrossRefGoogle Scholar
  6. 6.
    G. Morrison, E.L. Michelson, S. Brown, J. Morganroth: Mechanism and prevention of cardiac arrhythmias in chronic hemodialysis patients. Kidney Int. 17: 811–819 (1980).PubMedCrossRefGoogle Scholar
  7. 7.
    G.N. Corder, J. Sharma, R.H. McDonald: Variable levels of plasma catecholamines and dopamine beta-hydroxylase in hemodialysis patients. Nephron 25: 267–272 (1980).PubMedCrossRefGoogle Scholar
  8. 8.
    V. Wizemann, W. Kramer, T. Funke, G. Schutterle: Dialysis-indueed cardiac arrhythmias: Fact or fiction? Nephron 39: 356–360 (1985).PubMedCrossRefGoogle Scholar
  9. 9.
    B. Lown, M. Wolf: Approaches to sudden death from coronary heart disease. Circulation 44: 130 (1971).PubMedGoogle Scholar
  10. 10.
    B.T. Burton, K.K. Krueger, F.A. Bryan, Jr.: National registry of long-term dialysis patients. J.A.M.A. 218: 718–722 (1971).PubMedCrossRefGoogle Scholar
  11. 11.
    A. Lindner, B. Charra, D.J. Sherrard, B.H. Scribner: Accelerated atherosclerosis in prolonged maintenanace hemodialysis. New Engl. J. Med. 290: 697–701 (1974).Google Scholar
  12. 12.
    K. Scharar, F.P. Brunner, H. von Dehn, H.J. Gurland, H. Harlen, F.M. Parsons: Combined report on regular dialysis and transplantation of children in Europe. 1971. Proc. Eur. Dial. Transplant Ass. 10: 58 (1973).Google Scholar
  13. 13.
    M. Rodstein, L. Wolloch, R. Gubner: Mortality study of the significance of extrasystoles in an insured population. Circulation 44: 617 – 625 (1971).PubMedGoogle Scholar
  14. 14.
    B.N. Chiang, L.V. Perlman, L.D. Ostrander, Jr., F.H. Epstein: Relationship of premature systoles to coronary heart disease and sudden death in the Tecumseh epidemiologic study. Ann. Intern. Med. 70: 1159–1166 (1979).Google Scholar
  15. 15.
    K. Kimura, K. Tabei, S. Hosoda: Selection of the treatment and tachyarrhythmia in various myocardial disorders with regard to the myocardial damage in uremic patients. Nagoya, Japan, 1986 ( Suppl. )Google Scholar
  16. 16.
    S.G. Massry, J.W. Coburn, M.M. Popovtzer : Secondary hyperparathyroidism in chronic renal failure. The clinical spectrum in uremia, during hemodialysis and after renal trans-plantation. Arch. Intern. Med. 124: 431–441 (1969).Google Scholar
  17. 17.
    W.T. Clusin, M.R. Bristow, H.S. Karagueuzian, B.G. Katzung, J.S. Schroeder: Do calcium dependent ionic currents mediate ischemic ventricular fibrillation ? Am. J. Cardiol. 49: 606–612 (1982).PubMedCrossRefGoogle Scholar

Copyright information

© Plenum Press, New York 1989

Authors and Affiliations

  • Ken-ichi Kimura
    • 1
  • Kaoru Tabei
    • 2
  • Toshio Nakayama
    • 1
  • Yasushi Asano
    • 2
  • Saichi Hosoda
    • 1
  1. 1.Departments of Cardiology and NephrologyJichi Medical SchoolTochigiJapan
  2. 2.Departments of NephrologyJichi Medical SchoolTochigiJapan

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