Assessment of Comorbidity in Peritoneal Dialysis Patients

Which Method Should Be Used to Assess Protein Intake in Peritoneal Dialysis Patients? Assessment of Agreement Between Protein Equivalent of Total Nitrogen Appearance and 24-Hour Dietary Recall

Journal of Renal Nutrition ◽

10.1053/j.jrn.2020.08.003 ◽

2020 ◽

Author(s):

Maryanne Zilli Canedo Silva ◽

Barbara Perez Vogt ◽

Nayrana Soares Carmo Reis ◽

Rogerio Carvalho Oliveira ◽

Jacqueline Costa Teixeira Caramori

Keyword(s):

Peritoneal Dialysis ◽

Total Nitrogen ◽

Protein Intake ◽

Dialysis Patients ◽

Dietary Recall

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Prevalence of abnormalities in electrocardiogram conduction in dialysis patients: a comparative study

Brazilian Journal of Nephrology ◽

10.1590/10.1590/2175-8239-jbn-2020-0018 ◽

2020 ◽

Author(s):

Firas Ajam ◽

Arda Akoluk ◽

Anas Alrefaee ◽

Natasha Campbell ◽

Avais Masud ◽

...

Keyword(s):

Peritoneal Dialysis ◽

Cardiac Conduction ◽

Future Research ◽

Dialysis Patients ◽

Bundle Branch Block ◽

Conduction Abnormality ◽

Ckd Stage ◽

Stage 1 ◽

Electrocardiogram Ecg ◽

Ecg Abnormalities

ABSTRACT Background: The electrocardiogram (ECG) can aid in identification of chronic kidney disease (CKD) patients at high risk for cardiovascular diseases. Cohort studies describe ECG abnormalities in patients on hemodialysis (HD), but we did not find data comparing ECG abnormalities among patients with normal kidney function or peritoneal dialysis (PD) to those on hemodialysis. We hypothesized that ECG conduction abnormalities would be more common, and cardiac conduction interval times longer, among patients on hemodialysis vs. those on peritoneal dialysis and CKD 1 or 2. Methods: Retrospective review of adult inpatients’ charts, comparing those with billing codes for “Hemodialysis” vs. inpatients without those charges, and an outpatient peritoneal dialysis cohort. Patients with CKD 3 or 4 were excluded. Results: One hundred and sixty-seven charts were reviewed. ECG conduction intervals were consistently and statistically longer among hemodialysis patients (n=88) vs. peritoneal dialysis (n=22) and CKD stage 1 and 2 (n=57): PR (175±35 vs 160±44 vs 157±22 msec) (p=0.009), QRS (115±32 vs. 111±31 vs 91±18 msec) (p=0.001), QT (411±71 vs. 403±46 vs 374±55 msec) (p=0.006), QTc (487±49 vs. 464±38 vs 452±52 msec) (p=0.0001). The only significantly different conduction abnormality was prevalence of left bundle branch block: 13.6% among HD patients, 5% in PD, and 2% in CKD 1 and 2 (p=0.03). Conclusion: To our knowledge, this is the first study to report that ECG conduction intervals are significantly longer as one progresses from CKD Stage 1 and 2, to PD, to HD. These and other data support the need for future research to utilize ECG conduction times to identify dialysis patients who could potentially benefit from proactive cardiac evaluations and risk reduction.

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