Assessing arrhythmic risk in chronic kidney disease: A study of the index of cardiac-electrophysiological balance.

Abstract

Background: Chronic kidney disease (CKD) patients are at high risk of cardiovascular death and malignant arrhythmia. We aimed to determine at which CKD stage, the change in the index of cardiac-electrophysiological balance (ICEB) value is more evident. Consequently, we included patients across all CKD stages in our research.

Materials and methods: A total of 429 patients were followed up at the nephrology and cardiology outpatient clinics between April and November 2023 enrolled in the study. Patients were categorized into five groups based on their glomerular filtration rate (GFR) - Group 1: GFR ≥90, Group 2: GFR = 60-89, Group 3: GFR = 30-59, Group 4: GFR = 15-29 and not on hemodialysis, and Group 5: GFR ≤15 and on hemodialysis. Electrocardiograms were recorded, and ICEB and corrected ICEB (ICEBc) values were calculated for all patients.

Results: The mean age was 52.52 ± 14.58 years, and the total number of female patients was 235 (54.8%). In post hoc analysis, the difference of ICEBc value differed between Groups 1 and 5 (95% confidence interval: 0.0217-0.5226; P = 0.024). There were no statistically significant differences between Group 1 and the other groups. Corrected QT values were significantly different between Group 5 and Groups 1, 2, and 3 (P < 0.001, P < 0.001, and P = 0.005, respectively). The QT intervals were different between Group 1 and Groups 3, 4, and 5 (P = 0.003, P = 0.003, and P = 0.008, respectively).

Conclusion: The study demonstrated that the ICEBc value gradually increased with the progression of CKD stages, with a statistically significant change observed in stage 5. However, there was no significant difference in ICEB values across stages.