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Hyperkalemia and Electrocardiogram Manifestations in End-Stage Renal Disease

Author

Listed:
  • Zubaid Rafique

    (Henry JN Taub Department of Emergency Medicine, Baylor College of Medicine, Houston, TX 77030, USA)

  • Bryan Hoang

    (McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX 77004, USA)

  • Heba Mesbah

    (Henry JN Taub Department of Emergency Medicine, Baylor College of Medicine, Houston, TX 77030, USA)

  • Ryan Pappal

    (Washington University School of Medicine in St. Louis, St. Louis, MO 63110, USA)

  • Frank W. Peacock

    (Henry JN Taub Department of Emergency Medicine, Baylor College of Medicine, Houston, TX 77030, USA)

  • Raul Juarez-Vela

    (Group in Research in Care (GRUPAC), Department of Nursing, University of La Rioja, 93-103 Logrono, Spain)

  • Lukasz Szarpak

    (Henry JN Taub Department of Emergency Medicine, Baylor College of Medicine, Houston, TX 77030, USA)

  • Dick C. Kuo

    (Henry JN Taub Department of Emergency Medicine, Baylor College of Medicine, Houston, TX 77030, USA)

Abstract

Hyperkalemia is one of the more common acute life-threatening metabolic emergencies. The aim of our study is to determine the correlation and accuracy of abnormal ECG parameters as a function of serum potassium concentration in the end-stage renal disease (ESRD) population. We performed a retrospective chart review of emergency department patients presenting with ESRD and receiving emergent hemodialysis treatment. A total of 96 patients, each with five independent ED visits, provided 480 sets of ECGs and electrolytes. Of these, four ECGs were excluded for inability to interpret, leaving a total of 476 patient encounters that met all inclusion criteria. Linear regression analysis on the limited data set for serum potassium versus T/R in V2, V3, and V4, PR, and QRS found weak correlations (r 2 = 0.02 to 0.12) with statistical significance <0.05 level for T/R in V2, V3, and V4. In summary, we found that a QRS duration of 120 ms or greater is most predictive of hyperkalemia in the ESRD population. On the other hand, T/R ratio, PR interval and QRS duration have poor correlations with serum potassium and are not predictive of hyperkalemia in patients with ESRD.

Suggested Citation

  • Zubaid Rafique & Bryan Hoang & Heba Mesbah & Ryan Pappal & Frank W. Peacock & Raul Juarez-Vela & Lukasz Szarpak & Dick C. Kuo, 2022. "Hyperkalemia and Electrocardiogram Manifestations in End-Stage Renal Disease," IJERPH, MDPI, vol. 19(23), pages 1-11, December.
    • Handle: RePEc:gam:jijerp:v:19:y:2022:i:23:p:16140-:d:991528
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