Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Internal Medicine

Background: The risks of sudden cardiac death and arrhythmia are increased in patients with chronic kidney disease (CKD) and in those on hemodialysis. Aim: Evaluation of the predictors of arrhythmias, such as p-wave dispersion (P-WD), QTc dispersion and Tp-e/QT ratio in patients with CKD stages 3{u2013}5 on no renal replacement therapy (RRT) and ESRD patients on regular hemodialysis. Patients and methodology: One-hundred and ninety patients (seventy-five patients with CKD stages 3{u2013}5 not on RRT, seventy-five ESRD patients on regular hemodialysis and 40 healthy controls were enrolled into the study. All the patients were subjected to : 1- Laboratory evaluation including: CBC, urea, creatinine, (eGFR was calculated by CKD-EPI equation), serum potassium, serum magnesium, serum calcium, serum phosphorus, PTH, serum iron and TIBC (transferrin satutation was calculated). 2- Echocardiograohy to assess LV EF and to exclude those with with structural heart disease. 3- Electrocardiogram performed by electrophysiological study machine including: QTc dispersion, P-WD and Tp-e interval measurement and Tp- e/QT ratio calculation. Results: The mean age of patients with ESRD and CKD were found to be significantly higher than controls (46.44±13.97, 49.16 ±13.19 and 37.23±15.07 {u2009}y, p{u2009}<0{u2009}.001, respectively). Compared to controls, the values of P-WD (47.97±17.68 and 46.32±22.3 vs. 34.7±13.36{u2009}msec, p=0.001), QTc dispersion (88.17±31.89 and 76.93±30.99 vs. 59.25±22.15{u2009}msec, p{u2009}<{u2009}0.001) and Tp-e/QTc ratio (0.64±0.3 and 0.68±0.28 vs. 0.47±0.24, p{u2009}={u2009}0.002) were found to be significantly higher in the ESRD and CKD groups respectively

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