Effect of citric-acid dialysate on the QTC-interval

Abstract Lower dialysate calcium (dCa) concentration and dialysate citric-acidification may positively affect calcification propensity in serum of haemodialysis (HD) patients. However, the accompanying lower ionized blood calcium concentration may lead to a prolonged cardiac action potential, which...

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Autores principales:	Karlien J. ter Meulen, Ben J. M. Hermans, Frank M. van der Sande, Bernard Canaud, Constantijn J. A. M. Konings, Jeroen P. Kooman, Tammo Delhaas
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/797d4155edc14cd1af7677274702e5b9
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spelling	oai:doaj.org-article:797d4155edc14cd1af7677274702e5b92021-12-02T15:36:30ZEffect of citric-acid dialysate on the QTC-interval10.1038/s41598-021-89083-w2045-2322https://doaj.org/article/797d4155edc14cd1af7677274702e5b92021-05-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-89083-whttps://doaj.org/toc/2045-2322Abstract Lower dialysate calcium (dCa) concentration and dialysate citric-acidification may positively affect calcification propensity in serum of haemodialysis (HD) patients. However, the accompanying lower ionized blood calcium concentration may lead to a prolonged cardiac action potential, which is possibly pro-arrhythmic. The aim of this study is to investigate the influence of citric-acid dialysate on the QT-interval corrected for heart rate (QTc) compared to conventional dialysate with different dCa concentrations. We conducted a four-week multicentre, randomized cross-over trial. In week one and three patients received acetic-acid dialysate with a dCa of 1.50 mmol/l (A1.5), in week two and four acetic-acid dialysate with a dCa of 1.25 mmol/l (A1.25) or citric-acid dialysate (1.0 mmol/l) with a dCa of 1.50 mmol/l (C1.5) depending on randomization. Patients had continuous ECG monitoring during one session in week one, two and four. The data of 13 patients were available for analysis. Results showed a significant though limited increase of QTc with C1.5 (from 427 to 444 ms (start to end); p = 0.007) and with A1.25 (from 431 to 449 ms; p < 0.001), but not with A1.5 (from 439 to 443 ms; p = 0.13). In conclusion, we found that the use of C1.5 or A1.25 is associated with a significant prolongation of QTc which was however relatively limited.Karlien J. ter MeulenBen J. M. HermansFrank M. van der SandeBernard CanaudConstantijn J. A. M. KoningsJeroen P. KoomanTammo DelhaasNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-6 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Karlien J. ter Meulen Ben J. M. Hermans Frank M. van der Sande Bernard Canaud Constantijn J. A. M. Konings Jeroen P. Kooman Tammo Delhaas Effect of citric-acid dialysate on the QTC-interval
description	Abstract Lower dialysate calcium (dCa) concentration and dialysate citric-acidification may positively affect calcification propensity in serum of haemodialysis (HD) patients. However, the accompanying lower ionized blood calcium concentration may lead to a prolonged cardiac action potential, which is possibly pro-arrhythmic. The aim of this study is to investigate the influence of citric-acid dialysate on the QT-interval corrected for heart rate (QTc) compared to conventional dialysate with different dCa concentrations. We conducted a four-week multicentre, randomized cross-over trial. In week one and three patients received acetic-acid dialysate with a dCa of 1.50 mmol/l (A1.5), in week two and four acetic-acid dialysate with a dCa of 1.25 mmol/l (A1.25) or citric-acid dialysate (1.0 mmol/l) with a dCa of 1.50 mmol/l (C1.5) depending on randomization. Patients had continuous ECG monitoring during one session in week one, two and four. The data of 13 patients were available for analysis. Results showed a significant though limited increase of QTc with C1.5 (from 427 to 444 ms (start to end); p = 0.007) and with A1.25 (from 431 to 449 ms; p < 0.001), but not with A1.5 (from 439 to 443 ms; p = 0.13). In conclusion, we found that the use of C1.5 or A1.25 is associated with a significant prolongation of QTc which was however relatively limited.
format	article
author	Karlien J. ter Meulen Ben J. M. Hermans Frank M. van der Sande Bernard Canaud Constantijn J. A. M. Konings Jeroen P. Kooman Tammo Delhaas
author_facet	Karlien J. ter Meulen Ben J. M. Hermans Frank M. van der Sande Bernard Canaud Constantijn J. A. M. Konings Jeroen P. Kooman Tammo Delhaas
author_sort	Karlien J. ter Meulen
title	Effect of citric-acid dialysate on the QTC-interval
title_short	Effect of citric-acid dialysate on the QTC-interval
title_full	Effect of citric-acid dialysate on the QTC-interval
title_fullStr	Effect of citric-acid dialysate on the QTC-interval
title_full_unstemmed	Effect of citric-acid dialysate on the QTC-interval
title_sort	effect of citric-acid dialysate on the qtc-interval
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/797d4155edc14cd1af7677274702e5b9
work_keys_str_mv	AT karlienjtermeulen effectofcitricaciddialysateontheqtcinterval AT benjmhermans effectofcitricaciddialysateontheqtcinterval AT frankmvandersande effectofcitricaciddialysateontheqtcinterval AT bernardcanaud effectofcitricaciddialysateontheqtcinterval AT constantijnjamkonings effectofcitricaciddialysateontheqtcinterval AT jeroenpkooman effectofcitricaciddialysateontheqtcinterval AT tammodelhaas effectofcitricaciddialysateontheqtcinterval
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Effect of citric-acid dialysate on the QTC-interval

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