Evaluation of the Relationship Between Electrocardiographic Changes and the Calcium/Potassium Ratio in Patients with Acute and Chronic Renal Failure

Authors : Qatada Omar Mohammad Aldabbas, Ozlem Koksal, Melih Yüksel, Enad Kenan, Vahide Aslıhan Durak, Göksel Aydoğan

Pages : 285-290

Doi:10.32708/uutfd.1701404

View : 39 | Download : 69

Publication Date : 2025-08-28

Article Type : Research Paper

Abstract :The aim of this study was to investigate the relationship between serum calcium and potassium levels, as well as the calcium/potassium ratio, and electrocardiographic (ECG) changes in patients presenting to the emergency department with both renal failure and hyperkalemia. This cross-sectional study was conducted retrospectively by reviewing the medical records of patients diagnosed with renal failure and concomitant hyperkalemia (serum potassium>5.5 mEq/L) who presented to the emergency departments of a university hospital and a training and research hospital between November 1, 2022, and October 31, 2023. 55.4% of the patients were male, with a mean age of 68.31 ± 13.56 years. ECG abnormalities were detected in 69.5% of the cases. The most frequently observed ECG abnormalities were atrial fibrillation (22.0%) and peaked T waves (20.3%). Hemodialysis was performed in 52.5% of patients, 23.2% were admitted to the intensive care unit (ICU), and 15.8% died within 30 days of hospital presentation. Patients with T wave inversion had significantly lower potassium levels (6.42 ± 0.77 vs. 6.03 ± 0.71, p=0.018). In patients with any ECG abnormality, calcium levels (8.69 ± 0.87 vs. 8.36 ± 0.85, p=0.037) and calcium/potassium ratios (1.39 ± 0.19 vs. 1.32 ± 0.20, p=0.036) were significantly lower. The calcium/potassium ratio was also significantly lower in patients with peaked T waves (1.36 ± 0.20 vs. 1.27 ± 0.20, p=0.016). Among patients who died in-hospital or within 30 days, calcium/potassium ratios were significantly lower and potassium levels were significantly higher (p<0.05). In patients presenting to the emergency department with renal failure and concomitant hyperkalemia, the presence of ECG abnormalities was associated with lower calcium levels and a reduced calcium/potassium ratio. Moreover, 30-day mortality was found to be associated with higher potassium levels and a lower calcium/potassium ratio. These findings suggest that cardiac complications should be considered in clinical practice when hyperkalemia accompanies acute or chronic renal failure.
Keywords : kalsiyum, potasyum, EKG, acil servis

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