CARDIAC RHYTHM DISORDERS AND HYDROELECTROLYTIC ABNORMALITIES IN CHRONIC HEMODIALYSIS PATIENTS: IS THERE A CORRELATION

Introduction: Sudden death is most often due to severe arrhythmias such as ventricular fibrillation which are responsible for 25% of deaths. This is the first cause of death in the chronic hemodialyzed patient. Purpose: To study electrocardiographic disorders and metabolic abnormalities in chronic hemodialyzed patient before , during and after the hemodialysis session. Materials and Methods: This is a descriptive, prospective and analytical study carried out in collaboration with the Department of Cardiology and Nephrology of the University Hospital of Marrakech, over a period of 6 months including 56 chronic hemodialyzed patients who received a 24-hours electrocardiogram (EKG) and a biological check-up before and after their hemodialysis session. Results: The average age of our patients was 49.89 years with extremes ranging from 16 to 86 years. Female predominance was noted (51.78%) with an M/F sex ratio of 0.9. Causal nephropathy is undetermined in 44.6% of cases. Vascular initiation was by venous arterial fistula in 98.2% of cases. Sinus tachycardia was objectified in 9% of cases during dialysis and 7% after the session. The duration of the corrected QT was an average of 441ms, 445ms and 430ms before and after hemodialysis respectively with a statistically significant decrease. Isolated ventricular extrasystoles were objectified in 23.2% of the cases before, 26.8% of the cases during and 48.2% of the cases after the hemodialysis session. Hyperkalemia was noted in 82.1% of cases in before dialysis and hypercalcemia in 16.1% of cases after dialysis.? Conclusion: Metabolic variations during dialysis can lead to a significant risk of cardiac arrhythmias. Chronic hemodialysis should therefore benefit from regular monitoring of electrolytes and cardiovascular status to reduce morbi-mortality on dialysis.?