Association Between Disturbed Serum Phosphorus Levels and QT Interval Prolongation
Introduction: QT interval prolongation is a risk factor for fatal arrhythmias and other cardiovascular complications. QT interval prolongation in patients on hemodialysis (HD) is not well understood. Hypocalcemia is a suspected, but poorly verified etiology in these patients, and the association bet...
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Elsevier
2024-06-01
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| Series: | Kidney International Reports |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2468024924015493 |
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| author | Sho Sasaki Kiichiro Fujisaki Masato Nishimura Toshiaki Nakano Masanori Abe Norio Hanafusa Nobuhiko Joki |
| author_facet | Sho Sasaki Kiichiro Fujisaki Masato Nishimura Toshiaki Nakano Masanori Abe Norio Hanafusa Nobuhiko Joki |
| author_sort | Sho Sasaki |
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| description | Introduction: QT interval prolongation is a risk factor for fatal arrhythmias and other cardiovascular complications. QT interval prolongation in patients on hemodialysis (HD) is not well understood. Hypocalcemia is a suspected, but poorly verified etiology in these patients, and the association between serum phosphorus levels and QT interval prolongation is unknown. We sought to determine the prevalence of QT interval prolongation in patients on HD and to verify the association between predialysis serum calcium (Ca) and phosphate (P) levels and QT interval prolongation. Methods: A cross-sectional study was conducted on adult patients on maintenance HD who were enrolled in the Japanese Society for Dialysis Therapy and Renal Data Registry 2019. After assessing patient characteristics, linear regression analysis was performed with predialysis serum Ca and P levels as exposures and a rate-corrected QT (QTc) interval as the outcome. Results: A total of 204,530 patients were analyzed with a mean QTc of 451.2 (standard deviation, 36.9) ms. After multivariable analysis, estimated change in QTc (coefficients; 95% confidence interval) per 1 mg/dl increase in serum Ca and P was −2.02 (−3.00 to −1.04) and 5.50 (3.92–7.09), respectively. In the restricted cubic spline curve, estimated change in QTc increased with lower values of serum Ca. The correlation between serum P and QTc showed a U-shaped curve. Conclusion: Decreased serum Ca levels and decreased and increased serum P levels may be associated with QT interval prolongation in patients on maintenance HD. |
| format | Article |
| id | doaj-art-7b9f449b905a4681ae1232a4f55ba7ac |
| institution | OA Journals |
| issn | 2468-0249 |
| language | English |
| publishDate | 2024-06-01 |
| publisher | Elsevier |
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| series | Kidney International Reports |
| spelling | doaj-art-7b9f449b905a4681ae1232a4f55ba7ac2025-08-20T02:33:39ZengElsevierKidney International Reports2468-02492024-06-01961792180110.1016/j.ekir.2024.03.007Association Between Disturbed Serum Phosphorus Levels and QT Interval ProlongationSho Sasaki0Kiichiro Fujisaki1Masato Nishimura2Toshiaki Nakano3Masanori Abe4Norio Hanafusa5Nobuhiko Joki6Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University, Kyoto City, Kyoto, Japan; Center for Innovative Research for Communities and Clinical Excellence (CiRC2LE), Fukushima Medical University, Fukushima, JapanDepartment of Nephrology, Iizuka Hospital, Fukuoka, JapanToujinkai Satellite Clinic, Kyoto, JapanDepartment of Medical and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, JapanDivision of Nephrology, Hypertension and Endocrinology, Department of Medicine, Nihon University School of Medicine, Tokyo, JapanDepartment of Blood Purification, Tokyo Women`s Medical University, Tokyo, JapanDivision of Nephrology, Toho University Ohashi Medical Center, Tokyo, Japan; Correspondence: Nobuhiko Joki, Division of Nephrology, Toho University Ohashi Medical Center, 2-22-36, Ohashi, Meguro-ku, Tokyo, 153-8515, Japan.Introduction: QT interval prolongation is a risk factor for fatal arrhythmias and other cardiovascular complications. QT interval prolongation in patients on hemodialysis (HD) is not well understood. Hypocalcemia is a suspected, but poorly verified etiology in these patients, and the association between serum phosphorus levels and QT interval prolongation is unknown. We sought to determine the prevalence of QT interval prolongation in patients on HD and to verify the association between predialysis serum calcium (Ca) and phosphate (P) levels and QT interval prolongation. Methods: A cross-sectional study was conducted on adult patients on maintenance HD who were enrolled in the Japanese Society for Dialysis Therapy and Renal Data Registry 2019. After assessing patient characteristics, linear regression analysis was performed with predialysis serum Ca and P levels as exposures and a rate-corrected QT (QTc) interval as the outcome. Results: A total of 204,530 patients were analyzed with a mean QTc of 451.2 (standard deviation, 36.9) ms. After multivariable analysis, estimated change in QTc (coefficients; 95% confidence interval) per 1 mg/dl increase in serum Ca and P was −2.02 (−3.00 to −1.04) and 5.50 (3.92–7.09), respectively. In the restricted cubic spline curve, estimated change in QTc increased with lower values of serum Ca. The correlation between serum P and QTc showed a U-shaped curve. Conclusion: Decreased serum Ca levels and decreased and increased serum P levels may be associated with QT interval prolongation in patients on maintenance HD.http://www.sciencedirect.com/science/article/pii/S2468024924015493calciumhemodialysisphosphateQT interval prolongation |
| spellingShingle | Sho Sasaki Kiichiro Fujisaki Masato Nishimura Toshiaki Nakano Masanori Abe Norio Hanafusa Nobuhiko Joki Association Between Disturbed Serum Phosphorus Levels and QT Interval Prolongation Kidney International Reports calcium hemodialysis phosphate QT interval prolongation |
| title | Association Between Disturbed Serum Phosphorus Levels and QT Interval Prolongation |
| title_full | Association Between Disturbed Serum Phosphorus Levels and QT Interval Prolongation |
| title_fullStr | Association Between Disturbed Serum Phosphorus Levels and QT Interval Prolongation |
| title_full_unstemmed | Association Between Disturbed Serum Phosphorus Levels and QT Interval Prolongation |
| title_short | Association Between Disturbed Serum Phosphorus Levels and QT Interval Prolongation |
| title_sort | association between disturbed serum phosphorus levels and qt interval prolongation |
| topic | calcium hemodialysis phosphate QT interval prolongation |
| url | http://www.sciencedirect.com/science/article/pii/S2468024924015493 |
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