COMPARISON OF THE EFFECT OF ELECTROLYTE CHANGES ON ECGS OF PATIENTS PRESENTED IN EMERGENCY ROOM WITH RENAL FAILURE DURING PRE AND POST HAEMODIALYSIS AND THEIR CORRELATION

Abstract

Cardiovascular disease is a most common reason for mortality and morbidity among patients on haemodialysis. It is responsible for up to 30% of sudden death among patients during and sometime after dialysis. [7] During the dialysis session the rapid changes in intracellular and extracellular electrolytes leads to Cardiac arrhythmias immediately after a dialysis. [2] Potassium (K+) is the principle and most important intracellular cation. It is mainly regulated by the kidneys and excess potassium is excreted in urine and to a lesser extent from intestine. It plays an important role in maintaining the electrical potential across the cellular membrane and its blood level affects all types of neuromuscular activities. An alteration in the serum level of potassium may present with cardiovascular complications like cardiac arrhythmias and/or neuromuscular signs and symptoms [5]. Hyperkalaemia is a relatively common finding in patients with renal failure due to a consequence of tissue break down and decreased renal potassium excretion. [4] Severe Hyperkalaemia might occur in 10 -19% of haemodialysis (HD) patients [3]. Sudden shift and decrease in serum K+ alters the resting membrane potential, which is potentially arrhythmogenic especially in patients undergoing dialysis [8]. Sudden death is common among dialysis patients and the annual death rate for these patients is 230 per 1000 patient per year, ischemic heart disease and rapid electrolyte shift are the most common causes during dialysis sessions [3].