Ambulatory electrocardiographic changes in children with chronic renal insufficiency. a study of the effects of hemodialysis process

ABSTRACT

Ambulatory electrocardiographic [Holter] recording was done for 24 hours before and 24 hours after study of HD session in 26 pediatric patients with chronic renal insufficiency [CRI] on maintenance HD. This was a trial to evaluate the possible effect of HD process on the electrocardiographic pattern in those patients. Holter changes were observed during the last hour of HD session in 20 patients only [76.92%]. These were sinus tachycardia [ST] in 90%, supraventricular tachycardia [SVT] in 5% and bradycardia with first degree atrio- ventricular block in 5%. Premature supraventricular contractions [PSVC] were recorded in 40% of the patients with Holter changes and premature ventricular contractions [PVC] in 25% of the HD induced significant prolongation of Q-Tc interval in 75% of the patients with Holter changes [P <0.001] and significant shortening of it in 15% of them [P<0.001]. The degree of prolongation of Q-Tc interval showed significant positive correlation with degree of HD induced decrease in serum calcium [P <0.001] and in serum potassium [P <0.001]