Malnutrition and intervals PR, QRS, and QT in dialysis patients

Introduction/Objective: Electrocardiographic abnormalities are common in patients with hemodialysis and malnutrition. Material and methods: A retrospective study was performed in patients receiving hemodialysis, to describe the electrocardiographic alterations related to nutritional status, using bioelectrical impedance. Results: Two hundred twenty-four patients, 144 men and 80 women, 72.2 ± 0.8 years of age, 117 diabetics and 107 non-diabetics, and duration of dialysis treatment 81.2 ± 4.6 months. The electrocardiographic findings consisted of prolongation of the PR, QRS, and QTc intervals, which appeared in 30.7%, 17.4% and 62.1%, respectively; the upper limits were set at 0.20, 0.12 and 0.44 seconds. The PR segment was longer in men 0.191 ± 0.003 and 0.181 ± 0.004 seconds (p < 0.05), but there was no difference in the presence of diabetes. The QRS was longer in the presence of diabetes, 0.110 ± 0.002 and 0.104 ± 0.001 seconds (p < 0.05). The QTc was longer in women, 0.461 ± 0.004 and 0.445 ± 0.003 (p < 0.001), and in diabetics, 0.457 ± 0.003 and 0.445 ± 0.003 seconds (p < 0.01). PR and QRS intervals were not correlated with biochemical data, QTc was inversely correlated with creatinine and albumin levels (p < 0.001 and p < 0.001, respectively) and positively correlated with β2-microglobulin (p < 0.005), body mass index and geriatric nutritional risk index (p < 0.005 and p < 0.001, respectively). QTc was inversely correlated with total body water, intracellular water, fat-free mass and muscle mass (p < 0.01, p < 0.005, p < 0.005 and p < 0.01, respectively). PR segment was inversely correlated with intracellular water and positively correlated with edema proportion (p < 0.01 and p < 0.05, respectively). QRS segment was not correlated with bioimpedance results. Conclusions: QTc interval prolongation has a close correlation with malnutrition and hemodialysis.