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Hemodiafiltration and hemodialysis differently affect P wave duration and dispersion on the surface electrocardiogram

  • Nephrology - Original article
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Abstract

Aim

The incidence of atrial fibrillation is increased during hemodialysis (HD); however, the effects of hemodiafiltration (HDF) on atrial arrhythmias have not been evaluated. The prolongation of the P wave and P dispersion (Pd) can predict atrial arrhythmias.

Methods

Data from 30 patients receiving HDF over a period of 3 months were collected; the same group of patients was then evaluated during treatment with conventional HD for at least another 3 months. Electrolyte values were obtained, and surface electrocardiograms (ECG), echocardiography, and Holter ECGs were performed.

Results

The duration of the P wave and Pd increased significantly during HD. The left atrial diameter decreased significantly only during HDF. During HDF, the left atrial cross diameter measured at the beginning of the session was positively correlated with the incidence of supraventricular premature beats (p = 0.011, r = 0.4556). The decrease in left atrial diameter during HDF was negatively correlated with the incidence of supraventricular premature beats (p = 0.016, r = −0.43). During HDF, the changes in sodium and Pd were significantly positively correlated (p < 0.05, r = 0.478). During HD, the changes in ionized calcium levels and Pd were positively correlated (p < 0.05, r = 0.377).

Conclusion

Our results suggest that HDF has a more beneficial effect on P wave duration and Pd than HD. The alterations in the ECG markers may be the result of the simultaneous occurrence of certain electrolyte imbalances and renal replacement methods.

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Acknowledgments

Our research project was sponsored by the TÁMOP-4.2.2.A-11/1/KONV-2012-0045 and TÁMOP-4.2.6-151-2015-0001 projects. These projects are implemented through the New Hungary Development Plan and co-financed by the European Union and the European Social Fund.

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Authors and Affiliations

  1. Division of Emergency Medicine, Faculty of Medicine, Clinical Center, Institute of Medicine, University of Debrecen, Nagyerdei krt. 98, P.O. Box 19, 4032, Debrecen, Hungary

    Alida Páll, Árpád Czifra, Veronika Sebestyén, György Paragh, István Lőrincz & Zoltán Szabó

  2. Faculty of Medicine, Clinical Center, Institute of Cardiology, University of Debrecen, Debrecen, Hungary

    Csaba Kun

  3. Division of Nephrology, Faculty of Medicine, Clinical Center, Institute of Medicine, University of Debrecen, Debrecen, Hungary

    Gergely Becs, József Balla, Dénes Páll & Tamás János Padra

  4. Department of Medicine, Nephrology Research and Training Center and Center for Free Radical Biology, University of Alabama at Birmingham, Birmingham, AL, USA

    Anupam Agarwal & Abolfazl Zarjou

Authors
  1. Alida Páll
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  2. Árpád Czifra
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  3. Veronika Sebestyén
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  4. Gergely Becs
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  5. Csaba Kun
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  6. József Balla
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  7. György Paragh
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  8. István Lőrincz
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  9. Dénes Páll
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  10. Tamás János Padra
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  11. Anupam Agarwal
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  12. Abolfazl Zarjou
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  13. Zoltán Szabó
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Corresponding author

Correspondence to Zoltán Szabó.

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None of the authors have a relationship with companies that may have a financial or non-financial interest in the information contained in the manuscript. The authors have no other funding, financial relationships, or conflicts of interest to disclose.

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Páll, A., Czifra, Á., Sebestyén, V. et al. Hemodiafiltration and hemodialysis differently affect P wave duration and dispersion on the surface electrocardiogram. Int Urol Nephrol 48, 271–277 (2016). https://doi.org/10.1007/s11255-015-1144-4

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  • DOI: https://doi.org/10.1007/s11255-015-1144-4

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