Abstract
Continuous electrocardiographic (ECG) monitoring was performed over 24 h in 44 children at various stages of chronic renal failure in order to determine the incidence and nature of cardiac dysrhythmias. In addition the ECG was followed during haemodialysis sessions and during dialysate exchanges in continuous ambulatory peritoneal dialysis (CAPD) patients. In contrast to adult patients on haemodialysis life-threatening dysrhythmias were not observed. The proportion of children with premature ventricular complexes (41%) was at the upper limit of that in healthy children. A relatively high heart rate was found in children on CAPD, which varied during the exchange procedure. In 57% of all patients a transient marked prolongation of the QT interval up to 40% greater than normal was observed without obvious changes in the serum electrolyte levels. Continuous ECG monitoring is a useful tool for detecting alterations of cardiac rhythm and conduction in at-risk children with renal failure.
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O'Regan S (1984) Cardiovascular abnormalities in pediatric patients with ESRD. In: Fine RN, Gruskin AB (eds) End-stage renal disease in children. Saunders, Philadelphia, pp 359–374
Schärer K, Ulmer HE (1987) Cardiovascular complications of renal failure. In: Holliday MA, Barratt TM, Vernier RL (eds) Pediatric nephrology, 2nd edn. Williams and Wilkins, Baltimore, pp 887–896
Brunner FP, Broyer M, Brynger H, Dykes SR, Fassbinder W, Geerlings W, Rizzoni G, Selwood NH, Tufveson G, Wing AJ (1988) Demography of dialysis and transplantation in children in Europe 1985. Nephrol Dial Transplant 3:235–243
Mandel WJ, Peter CT, Bleifer SB (1987) Holter monitor recording. In: Mandel WJ (ed) Cardiac arrhythmias, 2nd edn. Lippincott, London, pp 578–587
Avram MM, Edson J, Gan A, Edson JN (1978) Continuous monitoring of cardiac rhythm in hemodialysis patients. Dial Transplant 7:516–517
Morrison G, Michelson EL, Brown S, Morganroth J (1980) Mechanisms and prevention of cardiac arrhythmias in chronic hemodialysis patients. Kidney Int 17: 811–819
Baldamus CA, Ernst W, Frei U, Koch KM (1982) Sympathetic and hemodynamic response to volume removal during different forms of renal replacement therapy. Nephron 31:324–332
Mello V de, Malone D, Thanavaro S, Kleiger RE, Kessler G, Oliver GC (1981) Cardiac arrhythmias in end-stage renal disease. South Med J 74:178–180
Blumberg A, Häussermann M, Strub B, Jenzer HR (1983) Cardiac arrhythmias in patients on maintenance hemodialysis. Nephron 33:91–95
Kyriakidis M, Voudiclaris S, Kremastinos D, Robinson-Kyriakidis C, Vyssoulis G, Zervakis D, Toutouzas P, Komninos Z, Avgoustakis D (1984) Cardiac arrhythmias in chronic renal failure. Nephron 38:26–29
Weber H, Schwarzer C, Stummvoll HK, Joskowics G, Wolf A, Steinbach K, Kaindl F (1984) Chronic hemodialysis: high risk patients for arrhythmias. Nephron 37: 180–185
Wizemann V, Kramer W, Funke T, Schütterle G (1985) Dialysis-induced cardiac arrhythmias: fact or fiction? Nephron 39:356–360
Grupo hemodialisi e patologie cardiovascolare (1988) Multicentre cross-sectional study of ventricular arrhythmias in chronically haemodialysed patients. Lancet II: 305–309
Hesslein PS (1981) Noninvasive diagnosis of dysrhythmias. In: Gillette PC, Gawson A (eds) Pediatric cardiac dysrhythmias. Grune and Stratton, New York, pp 59–76
Davignon A, Rautaharju P, Boisselle E, Soumis F, Megelas M, Choquette A (1979/80) Normal ECG standards for infants and children. Pediatr Cardiol 1:123–131
Gutheil H (1980) Kinder-EKG 3rd edn. Thieme, Stuttgart, pp 13–22, 145–182
Bazett HC (1918) An analysis of the time relation of electrocardiogram. Heart 7:353–370
Bosch A (1989) Herzrhythmusstörungen bei chronischer Niereninsuffizienz im Kindesalter. Thesis, University of Heidelberg
Lindinger A, Hoffmann W (1984) Langzeit-EKG-Befunde bei herzgesunden Kindern. Pediatr Paedol 19:59–70
Southall DP, Johnston F, Shinebourne EA, Johnston PGB (1981) 24 hours electrocardiographic study of heart rate and rhythm patterns in population of healthy children. Br Heart J 45:281–291
Scott O, Williams GJ, Fiddler GI (1980) Results of 24 hours ambulatory monitoring of the electrocardiogramm in 131 healthy boys aged 10 to 13 years. Br Heart J 44: 304–308
Dickinson DF, Scott O (1984) Ambulatory electrocardiographic monitoring in 100 healthy teenage boys. Br Heart J 51:179–183
Romano M, Charizia M, Onofrio E, Caiazzo MR, Adinolfi L, Cutillo S, Chiariello M, Condorelli M (1988) Heart rate, PR and QT intervals in normal children: a 24 hour Holter monitoring study. Clin Cardiol 11:839–842
Brodsky M, Wu D, Denes P, Kanakis C, Rosen KM (1977) Arrhythmias documented by 24 hour continuous electrocardiographic monitoring in 50 male medical students. Am J Cardiol 39:390–395
Germain C, Davignon A, O'Regan S (1987) Electrocardiographic monitoring in children with end-stage renal disease. Dial Transplant 16:250–251
Rauh W, Hund E, Sohl G, Rascher W, Mehls O, Schärer K (1983) Vasoactive hormones in children with chronic renal failure. Kidney Int 24 (Suppl 15]:27–33
Rutsky EA (1987) Bradycardic rhythms during peritoneal dialysis. Arch Intern Med 128:445–447
Axelrod S, Lishner M, Oz O, Bernheim J, Ravid M (1987) Spectral analysis of fluctuations in heart rate: an objective evaluation of autonomic nervous control in chronic renal failure. Nephron 45:202–206
Diskin CJ, Salzsieder KH, Solomon RJ, Carvalho JS, Trebbin WM (1981) Electrocardiographic changes following dialysis. Nephron 27:94–100
Ulmer HE (1978) Das Herz bei chronischer Niereninsuffizienz im Kindesalter. Habilitationsschrift (Thesis), University of Heidelberg
Weber HP, Michalk D, Rauh W, Romahn A, Schärer K (1980) Total body potassium in children with chronic renal failure. Int J Pediatr Nephrol 1:42–47
Krivoshiev V, Kirjakov Z, Antonov S, Zlatarska S, Vazelov E (1985) Is the prolonged QT-interval in the ECG of patients on dialysis treatment a manifestation of uremic polyneuropathy. Kidney Int 28:339
Attwell D, Lee JA (1988) A cellular basis for the primary long QT syndromes. Lancet I:1136–1138
Ulmer HE, Hempel EW, Schärer K (1982) Long-term evaluation of cardiac function utilizing systolic time intervals in children with chronic renal failure. Int J Pediatr Nephrol 1:42–47
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Bosch, A., Ulmer, H.E., Emil Keller, H. et al. Electrocardiographic monitoring in children with chronic renal failure. Pediatr Nephrol 4, 140–144 (1990). https://doi.org/10.1007/BF00858825
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DOI: https://doi.org/10.1007/BF00858825