Haemodialysis-induced electrolyte variation (serum calcium, magnesium and bicarbonate) and intradialytic heart rhythm disorders

Introduction Heart rhythm disorders (HRD) are common in patients with chronic renal failure (CRF) on maintenance dialysis (Burton et al 2008). Arrhythmias are more likely to occur if there are electrolytes imbalance, anemia, hypoxemia or blood pressure variations. Uremic cardiomyopathy is characterized by interstitial fibrosis, which may lead to myocardial electrical instability (Leier et al 1992). There are many factors that work together for intradialytic HRD occurrence. Several triggers act on organic heart disease, resulting in the production of arrhythmias during dialysis. Intradialytic variability of these factors, as well as their interdependence, contribute to the validation of the proarrhythmogenic effect of dialysis (Kramer et al 1992; Selby et al 2007). Haemodialysis predisposes to sudden changes of serum electrolytes level. Serum calcium, magnesium and blood pH imbalance are usually met in dialyzed patients and are often associated with arrhythmias (Voroneanu et al 2009; Santoro et al 2006). Our objectives were : recording HRD during haemodialysis, determination of calcemia, magnesemia and serum bicarbonate level, before and after dialysis and definition of variation types of the analysed electrolytes and their correlation with intradialytic HRD.