P-wave and QT Interval Dispersion Analysis in Children with End Stage Renal Disease on Regular Hemodialysis

Objectives: The consequences of hemodialysis on P-wave dispersion and QT dispersion have not been unequivocally documented and understood and may be complex. To investigate homogeneity disorders of atrial conduction and ventricular repolarization and tendency to develop various arrhythmias by demonstrating the effects of hemodialysis in children with end stage renal disease through assessment of P-wave dispersion and QT dispersion (By electrocardiograghy).

Methods: Twenty end stage renal disease patients on conventional hemodialysis for at least 12 months and twenty healthy, age and sex matched volunteers were included. Patients underwent echocardiography to exclude any abnormalities of cardiac valves or muscle. A 12-lead electrocardiogram was undertaken in order to measure minimal and maximal (P wave and QT interval) durations, P wave dispersion and QT dispersion.

Results: In patient group, males were 13, females were 7 with mean age of 11.9 ± 3.4 years, mean P wave dispersion and QT dispersion were significantly longer than control group. P wave dispersion was significantly shorter after dialysis (mean= 34 ± 13.1 ms) than before dialysis (mean=42.4 ± 14 ms), whereas QT dispersion was longer after dialysis (59 ± 19 ms) than before dialysis (55.5 ± 17 ms) but the differences in QT dispersion was not significant. Also, there was no correlation between neither P wave dispersion nor QT dispersion and the electrolytes.

Conclusion: P wave dispersion and QT dispersion was found to be higher in end stage renal disease children on regular hemodialysis than healthy control subjects, indicating heterogeneity disorders of atrial conduction and ventricular repolarization in these patients and tendency to develop various arrhythmias.