Relationship between electrocardiographic findings and long-term prognosis in patients with chronic kidney disease

Abstract

Patients diagnosed as having chronic kidney disease (CKD) are known to be at a high risk not only for progression to end-stage renal disease, but also for cardiovascular disease and sudden death. Only a few studies have shown the association between CKD and electrocardiographic (ECG) parameters. We aimed to study prognostic factors based on ECG parameters in patients with CKD. Among 16,424 patients who underwent evaluation with 12-lead ECG and blood sampling between April 2009 and March 2010, 3,325 patients with an estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m² were included in this study. We excluded 3,509 patients diagnosed as having atrial fibrillation and ventricular arrhythmia. Univariate and multivariate analyses were carried out to assess the association of age, sex, severity of CKD, and ECG parameters (heart rate, PR interval, QRS interval, QTc interval, and left ventricular hypertrophy) with cardiovascular/noncardiovascular death. Heart rate > 100 bpm and a QTc interval ≥ 440 were significant markers of risk of both cardiovascular and noncardiovascular death. In patients diagnosed as having CKD, a heart rate > 100 bpm and a QTc interval ≥ 440 were factors for poor long-term prognosis independent of age, sex, and severity of CKD.