Hyperkalemia and Electrocardiogram Manifestations in End-Stage Renal Disease

Zubaid Rafique, Bryan Hoang, Heba Mesbah, Ryan Pappal, Frank W. Peacock, Raul Juarez-Vela, Lukasz Szarpak () and Dick C. Kuo
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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

IJERPH, 2022, vol. 19, issue 23, 1-11

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.

Keywords: hyperkalemia; potassium; electrocardiogram; dysrhythmia (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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