Abstract: Background: Cardiovascular disease is the leading cause of mortality among patients on chronic
hemodialysis (HD). 30% of the deaths in these patients are due to cardiac arrest, death of unknown cause or cardiac
arrhythmia. The increasing time of ventricular depolarization and repolarization, measured by QT interval duration
on the electrocardiogram (ECG) at rest, has emerged as a predictor of complex ventricular arrhythmias. Objectives:
To determine ECG alterations in chronic (HD) children before and after HD. Design: Cross sectional study. Setting:
Pediatric HD unit of Sohag University Hospital, Sohag, 2016. Methods: after obtaining consents from all patients
less than 18 years on dialysis, they were submitted to the examination of a 12-lead ECG: heart rate, QRS duration,
QRS amplitude, T-wave amplitude and QT interval was measured 10 min pre and post-HD, and QT interval was
corrected for heart rate using Bazett’s formula. Children were monitored during dialysis session by 3 leads ECG to
detect any sustained arrhythmia. Main outcome measures: 12-lead electrocardiogram. Results: 20 patients on
regular HD were included in the study. 75% of them were females; the average age was 12.9 (3.7) years old and
55% of all patients had QTc prolongation before dialysis. No significant QTc prolongation occurred after dialysis.
HD leaded to a significant increase in the QRS explained by the decrease of the extracellular fluid and blood volume
and hence a decrease of the cardiac preload. HD also decrease of the T-wave amplitude explained by potassium
decrease during HD. PVCs observed in the ECG of 3 children after dialysis. No sustained arrhythmias occurred to
our patients during dialysis sessions. Conclusion: children on chronic HD had high frequency of abnormal ECG
findings, especially prolonged QTc interval. Limitation: the studied cohort was small that may weaken the
statistical power of the study.
[Montaser Mohamed Mohamed; Rasha Abd Elhameed Ali and Shaimaa Mohamed Mahmoud.
Electrocardiographic changes in chronic hemodialysis children at Sohag university hospital. J Am Sci
2016;12(8):99-104]. ISSN 1545-1003 (print); ISSN 2375-7264 (online).