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Effect of acetate‐free biofiltration with a potassium‐profiled dialysate on the control of cardiac arrhythmias in patients at risk: A pilot study
Author(s) -
MUÑOZ Rosa I.,
MONTENEGRO Jesús,
SALCEDO Alberto,
GALLARDO Isabel,
MARTÍNEZ Isabel,
QUINTANILLA Nuria,
SARACHO Ramón,
LEKUONA Iñaki
Publication year - 2008
Publication title -
hemodialysis international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.658
H-Index - 47
eISSN - 1542-4758
pISSN - 1492-7535
DOI - 10.1111/j.1542-4758.2008.00250.x
Subject(s) - medicine , hemodialysis , dialysis , potassium , cardiology , hyperkalemia , atrial fibrillation , coronary artery disease , anesthesia , chemistry , organic chemistry
Cardiac arrhythmias are a frequent event in chronic hemodialysis patients. The aim of this study was to evaluate the efficacy and safety of acetate‐free hemofiltration with potassium‐profiled dialysate (AFB‐K) dialysis compared with constant potassium acetate‐free biofiltration (AFB). Twelve patients (mean age 79 years) affected by cardiac arrhythmias or at a high risk for arrhythmia (advanced age, hypertension, left ventricular hypertrophy, heart valve disease, coronary artery disease, diabetes, paroxysmal atrial fibrillation) participated in a single‐center, sequential cohort study. All were treated with hemodialysis 3 times per week, using constant potassium AFB for the first 3 weeks, followed by an AFB‐K dialysate for the subsequent 3 weeks. The hemofilter, duration of dialysis, and electrolyte concentration were the same in both treatments. Both AFB‐K and constant potassium AFB dialytic techniques were safe and well tolerated. The results of biochemical tests were similar, except for serum potassium levels after 2 hr of dialysis, which were significantly higher in the AFB‐K group (4.0 mmol/L) than in the constant potassium AFB group (3.6 mmol/L) (p<0.001). All cardiac variables improved during AFB‐K dialysis. There was a significant reduction of postdialysis QT intervals corrected for heart rate in the AFB‐K group (448.8 ms) compared with the constant potassium AFB group (456.8 ms) (p=0.039). The severity and mean number of ventricular extasystoles also decreased (163.5 vs. 444.5/24 hr). Potassium profiling during hemodialysis treatment may be beneficial for patients with arrhythmias or at those risk of arrhythmias, particularly those with predialysis hyperkalemia.