Table 2.
The prevalence and outcomes of long QT syndrome in CKD patients.
| First author and year | Patients and follow-up | Results |
|---|---|---|
| Nappi et al. [4] | 23 ESRD patients were treated with different Ca++ concentrations dialysate. | The QTc interval were measured before and after the three sessions. QTc increased after dialysis, which related with low Ca++ concentrations dialysate (1.25 mmol/L). |
| Beaubien et al. [14] | 147 patients on maintenance HD (N = 49) or peritoneal (N = 98) dialysis. 5–9 years of follow-up. |
A prolonged QTdc (>74 ms) was detected in 46.9% and 52% of HD and peritoneal dialysis patients, respectively. QTdc was associated with the presence of diabetes mellitus, mean QT interval, corrected calcium levels. QTdc was an independent predictor of total (RR = 1.53) and CV mortality (RR = 1.57). |
| Maule et al. [33] | 69 ERSD patients and 12 subjects with normal renal function. | Compared to controls, ESRD patients showed a longer QTc (p = .016). After the HD session, QTc increased in 56% and decreased in 43% of the patients. |
| Familoni et al. [2] | 42 patients on hemodialysis and 45 control subjects. | The prevalence of prolonged QTc was higher in dialysis patients compared with control subjects (p < .05). The maximum QTc was longer than 440 ms in 71.4% of patients post-dialysis. The in-hospital mortality was not statistically different between the prolonged QTc group (73.3%) and normal group (66.7%) in hemodialysis patients. |
| Kestenbaum et al. [13] | 3238 participants with and without CKD. 9.2 years of follow-up. |
Participants with CKD had longer QTc intervals compared with those without CKD. Each 5% increase in QTI was associated with a 42% (95% CI 1.23–1.65), 22% (95% CI 1.07–1.40) and 10% (95% CI 0.98–1.22) greater risk of HF, CHD and mortality, respectively. |
| Patane et al. [1] | Study present a case of torsade de pointes in an 82-year-old Italian woman with chronic renal failure. | It reported that (QTc interval prolongation and torsade de pointes are associated with ESRD and that they can be a cause of SCD in ESRD. |
| Hage et al. [10] | 280 ESRD patients evaluated for transplantation. 40 ± 28 months of follow-up. |
39% of patients exhibited a prolonged QTc (460 ms). Patients with a prolonged QTc (39%) had 1-, 3-, and 5-year death-rates of 12%, 36%, and 47%, respectively, vs 8%, 24%, and 36% for those with normal QTc (p = .03). The prolonged QTc was an independent predictor of mortality in ESRD patients (HR: 1.008) |
| Genovesi et al. [7] | 122 patients undergoing HD were studied. 3.9 years of follow-up. |
44 patients (36.0%) had a prolonged QTc. 51 patients died (41.8%), of whom 12 died for SCD. In multivariate analysis, prolonged QTc (HR = 2.16) were independently associated with total mortality and SCD. |
| Khosoosi et al. [5] | 58 patients with chronic renal disease on chronic HD. The QTc was assessed 30 minutes before and after HD. | The mean of corrected QTc intervals increased significantly from 423.45 ± 24.10 to 454.41 ± 30.25 ms (p < .05). The changes in serum potassium and calcium levels were related with QT interval prolongation. |
| Flueckiger et al. [11] | 930 adult ESRD patients evaluated for renal transplantation. 3.1 years of follow-up. |
456 patients (49%) had a prolonged QTc. 108 (11.6%) patients died. Patients with 2 or more ECG interval prolongations had a 2.5-fold increased likelihood of dying vs. patients with no ECG interval prolongations (HR 2.53). |
| Sherif et al. [3] | 154 CKD patients without structural heart disease or medications that are known to prolong QT interval. | QTc interval prolongation was present in 63.6% of the cases (63% of females and 64% of males), and severely prolonged (>500ms) in 19.5% (19.4% of females and 19.6% of males). QTc interval was significantly prolonged across increasing stages of CKD severity (p < .006). |
| Malik et al. [12] | Study followed 6565 participants with and without CKD. 13.3 years of follow-up. |
CKD group had prolonged QTc than those without CKD (20.5%vs12.9%, p < .0001). Both prolonged QTc and CKD are independently associated with increased risk of mortality. When combined, risk of mortality is higher in those with CKD by eGFR with prolonged QTc than normal QTc (HR 2.6) and (HR 3.1) vs (HR 1.4) and (HR 1.7) for all-cause and CV mortality. |
| Liu et al. [8] | The prevalence of aLQTS was evaluated in 804 CKD patients. | The prevalence of aLQTS is much higher and increases with the decline of kidney function in hospitalized CKD patients, which is related to older age, impaired kidney function, hemodialysis, serum potassium and low LVEF. |
LQTS: acquired long QT syndrome; CHD: coronary heart disease; CKD: chronic kidney disease; CV: cardiovascular; ECG: electrocardiograph; eGFR: estimated glomerular filtration rate; ESRD: end-stage renal disease; HD: hemodialysis; HF: heart failure; HR: hazard ratio; LVEF: left ventricular ejection fraction; QTc: corrected QT; QTd: QT dispersion; QTdc: corrected QT dispersion; QTI: QT prolongation index; SCD: sudden cardiac death.