19th March 09:33
Sudden death in dialysis patients / iron (dialysis renal calcium peritoneal dialysis left ventricle)
This article shows iron stores cause death by heart attack ..
A value of 74 ms has been associated with risk for serious arrhythmias related
to sudden death in dialysis patients.
A linear relationship showed that at 74 ms of QTc dispersion, TSAT was 35.2%
Am J Kidney Dis. 2004 Oct;44(4):720-8. Related Articles, Links
The effect of iron stores on corrected QT dispersion in patients undergoing
Wu VC, Huang JW, Wu MS, Chin CY, Chiang FT, Liu YB, Wu KD.
Department of Internal Medicine, Far Eastern Memory Hospital, Taipei, Taiwan.
BACKGROUND: Arrhythmia and sudden death represent striking features in patients
with end-stage renal disease (ESRD). Increased QT dispersion has been shown to
be associated with arrhythmias. Abnormal excitability and heterogeneous cardiac
iron deposition may cause the arrhythmogenesis of human siderotic heart
disease. Iron overload and precipitation with its toxicity in cardiac muscles
may, therefore, cause QT prolongation in dialysis patients. METHODS: A total of
102 (65 women, 37 men; mean age, 47.7 +/- 13.4 years) nondiabetic patients
undergoing peritoneal dialysis (PD) were enrolled in this study. Another 102
subjects with a serum creatinine level less than 1.5 mg/dL (133 micromol/L)
were used as matched control subjects. The PD patients were divided into 2
groups according to whether their computerized measurements of corrected QT
(QTc) dispersion were longer than 74 ms. A value of 74 ms has been associated
with risk for serious arrhythmias related to sudden death in dialysis patients.
RESULTS: The QTc dispersion of PD patients was significantly longer than that
of the control subjects (69.8 +/- 40.0 versus 55.2 +/- 33.6 ms; P < 0.01).
Thirty-eight PD patients with QTc dispersion longer than 74 ms had lower blood
pressure ( P = 0.01), fewer left ventricle masses ( P = 0.036), and lower serum
albumin levels (P = 0.046) but higher levels of serum calcium (P = 0.038) and
transferrin saturation (TSAT; P = 0.022) than the other patients. Multivariate
****ysis identified TSAT as an independent factor for QTc dispersion (r =
0.432, P < 0.001). A linear relationship showed that at 74 ms of QTc
dispersion, TSAT was 35.2%. CONCLUSION: Long-term PD patients have longer QTc
dispersion than subjects with normal renal function. The high body iron stores
in these patients increase the risk of increased QT dispersion. The concern
over iron overload in dialysis patients is not only because of its oxidative
toxicity, but also its precipitation of arrhythmias, which may be measured by
the surrogate marker of QTc dispersion.
PMID: 15384024 [PubMed - in process]
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