ASSOCIATION BETWEEN CHRONIC KIDNEY DISEASE AND CHANGES IN THE T PEAK-T END INTERVAL AMONG HEMODIALYSIS PATIENTS AT RAA SOEWONDO PATI REGIONAL HOSPITAL
DOI:
https://doi.org/10.31004/prepotif.v9i3.50730Keywords:
Chronic Kidney Disease, TpTe Interval, Hemodialysis, Diabetes Mellitus, HypertensionAbstract
Secara global, prevalensi penyakit ginjal kronis (PGK) mencapai 359 juta kasus pada tahun 2021, dengan kematian terkait PGK meningkat sebesar 176% dalam periode yang sama, mencapai 1,53 juta kematian. Interval T peak-T end (TpTe), yang mewakili dispersi repolarisasi transmural, telah muncul sebagai penanda elektrokardiografi (EKG) kritis untuk aritmogenesis ventrikel. Penelitian telah menunjukkan bahwa perpanjangan interval TpTe secara substansial terkait dengan peningkatan risiko kematian jantung mendadak. Penelitian ini bertujuan untuk mengetahui hubungan antara CKD dan perubahan interval TpTe pada pasien hemodialisis. Sebuah penelitian observasional dengan desain potong lintang dilakukan di RSUD RAA Soewondo Pati pada September-November 2024. Pengumpulan data menggunakan teknik pengambilan sampel secara konsekutif. EKG dilakukan pada pasien selama hemodialisis. Kami menggunakan uji-T tidak berpasangan untuk pengujian statistik. Lima puluh pasien memenuhi kriteria inklusi dalam penelitian ini, berusia 43-65 tahun. Sebanyak 48% pasien PGK mengalami pemanjangan interval TpTe pada EKG selama hemodialisis dengan nilai rata-rata 98,2 ± 12,7 ms. Komorbiditas seperti hipertensi dan diabetes mellitus meningkatkan risiko PGK masing-masing sebesar 1,9 kali lipat dan 1,87 kali lipat. Pasien dengan PGK ≥ 6 bulan memiliki pemanjangan TpTe rata-rata yang signifikan lebih besar, yaitu 11 ms, dibandingkan dengan pasien dengan PGK < 6 bulan.References
Ameer O. Z. (2022). Hypertension in chronic kidney disease: What lies behind the scene. Frontiers in pharmacology, 13, 949260. https://doi.org/10.3389/fphar.2022.949260
Bonato, F.O.B., & Canziani, M.E.F. (2017). Ventricular arrhythmia in chronic kidney disease patients. Brazilian Journal of Nephrology, 39(2), 186-195. https://doi.org/10.5935/0101-2800.20170033
Candemir, M., Demir, M.E., Candemir, B., Nurkoc, S.G. (2021). An Evaluation of Tp-e Interval and its Associations with Electrolyte Imbalances in the Electrocardiography of Elderly Patients on Hemodialysis. Anatolian Clinic Journal of Medical Sciences, 26(2), 194-200. https://doi.org/10.21673/anadoluklin.790495
Damtie, S., Biadgo, B., Baynes, H. W., Ambachew, S., Melak, T., Asmelash, D., & Abebe, M. (2018). Chronic Kidney Disease and Associated Risk Factors Assessment among Diabetes Mellitus Patients at A Tertiary Hospital, Northwest Ethiopia. Ethiopian journal of health sciences, 28(6), 691–700. https://doi.org/10.4314/ejhs.v28i6.3
Foley, R.N., Gilbertson, D.T., Murray, T., Collins, A.J. (2011). Long Interdialytic Interval and Mortality among Patients Receiving Hemodialysis. The New England Journal of Medicine, 365(12), 1099-1107. https://doi.org/10.1056/NEJMoa1103313
Guclu, A., Sipahioglu, M.H., Icli, A., Alpay, M.F., Narman, S. (2016). Tp-e/QT and Tp-e/QTc Ratio in Hemodialysis and Peritoneal Dialysis Patients. Turkish Journal of Nephrology, 25(3), 273-278. https://doi.org/10.5262/tndt.2016.1003.10
Guo, J., Liu, Z., Wang, P., Wu, H., Fan, K., Jin, J., … & Li, C. (2025). Global, regional, and national burden inequality of chronic kidney disease, 1990–2021: a systematic analysis for the global burden of disease study 2021. Frontiers in Medicine, 11. https://doi.org/10.3389/fmed.2024.1501175
Hidayangsih, P. S., Tjandrarini, D. H., Sukoco, N. E. W., Sitorus, N., Dharmayanti, I., & Ahmadi, F. (2023). Chronic kidney disease in Indonesia: evidence from a national health survey. Osong public health and research perspectives, 14(1), 23–30. https://doi.org/10.24171/j.phrp.2022.0290
Indonesian Society of Nephrology. (2018). 11th Annual Report of Indonesian Renal Registry 2018. Bandung: Indonesian Society of Nephrology.
Koca, H., & Koc, M. (2020). What is the Normal Value of Tpe Interval and Corrected Tpe Interval?. Acta Medica, 51(4), 10-15. https://doi.org/10.32552/2020.ActaMedica.493
Kollu, K., Altintepe, L., Duran, C., Topal, M., & Ecirli, S. (2018). The assessment of P-wave dispersion and myocardial repolarization parameters in patients with chronic kidney disease. Renal failure, 40(1), 1–7. https://doi.org/10.1080/0886022X.2017.1419962
Lee, H., Kwon, S. H., Jeon, J. S., Noh, H., Han, D. C., & Kim, H. (2022). Association between blood pressure and the risk of chronic kidney disease in treatment-naïve hypertensive patients. Kidney research and clinical practice, 41(1), 31–42. https://doi.org/10.23876/j.krcp.21.099
Liyanage, T., Toyama, T., Hockham, C., Ninomiya, T., Perkovic, V., Woodward, M., … & Jun, M. (2022). Prevalence of chronic kidney disease in Asia: a systematic review and analysis. BMJ Global Health, 7(1). https://gh.bmj.com/content/7/1/e007525
Makmun, A., Satirapoj, B., Tuyen, D. G., Foo, M. W. Y., Danguilan, R., Gulati, S., … & Tang, S. C. W. (2025). The burden of chronic kidney disease in the Asia region: a review of the evidence, current challenges, and future directions. Kidney research and clinical practice, 44(3), 411–433. https://doi.org/10.23876/j.krcp.23.194
Mulia, E.P.B., Fauzia, K.A., Julario, R. (2022). High Risk of Ventricular Repolarization Abnormalities among End-Stage Hemodialytic Renal Disease Patients. Folia Medica, 64(6), 905-912. https://doi.org/10.3897/folmed.64.e68349
Noppakun, K., Putchagarn, P., Phrommintikul, A., Wongcharoen, W. (2021). Effects of interdialytic interval on heart rate variability in chronic hemodialysis patients: a cross-sectional study. Scientific Reports, 11, 20944. https://doi.org/10.1038/s41598-021-00093-0
Pall, A., Sebestyen, V., Czifra, A., Becs, G., Agarwal, A., Abolfazl, Z., … & Szabo, Z. (2017). The disparate effects of hemodialysis and hemodiafiltration on T-wave-peak-to-end interval (Tpe) and Tpe/QT ratio of the surface electrocardiogram. Trauma and Emergency Care, 2(5), 1-6. https://doi.org/10.15761/TEC.1000142
Panikkath, R., Reinier, K., Uy-Evanado, A., Teodorescu, C., Hattenhauer, J., Mariani, R., … & Chugh, S.S. (2011). Prolonged Tpeak-to-Tend Interval on the Resting ECG Is Associated With Increased Risk of Sudden Cardiac Death. Circulation: Arrhythmia and Electrophysiology, 4(4). https://doi.org/10.1161/CIRCEP.110.96065
Saour, B. M., Wang, J. H., Lavelle, M. P., Mathew, R. O., Sidhu, M. S., Boden, W. E., … & Asif, A. (2019). TpTe and TpTe/QT: novel markers to predict sudden cardiac death in ESRD?. Jornal brasileiro de nephrologia, 41(1), 38–47. https://doi.org/10.1590/2175-8239-JBN-2017-0021
Siddiqui, K., George, T. P., Joy, S. S., & Alfadda, A. A. (2022). Risk factors of chronic kidney disease among type 2 diabetic patients with longer duration of diabetes. Frontiers in endocrinology, 13, 1079725. https://doi.org/10.3389/fendo.2022.1079725
Torres, Y.C., Puerta, R.C., Katholi, R.E. (2015). Ventricular repolarization Markers for Predicting Malignant Arrhythmias in Clinical Practice. World J Clin Cases, 3(8), 705-720.
Turakhia, M. P., Blankestijn, P. J., Carrero, J. J., Clase, C. M., Deo, R., Herzog, C. A., Kasner, S. E., Passman, R. S., Pecoits-Filho, R., Reinecke, H., Shroff, G. R., Zareba, W., Cheung, M., Wheeler, D. C., Winkelmayer, W. C., Wanner, C., & Conference Participants (2018). Chronic kidney disease and arrhythmias: conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference. European heart journal, 39(24), 2314–2325. https://doi.org/10.1093/eurheartj/ehy060
Wan, C., Herzog, C.A., Zareba, W., Szymkiewicz, S.J. (2013). Sudden Cardiac Arrest in Hemodialysis Patients with Wearable Cardioverter Defibrillator. Annals of Noninvasive Electrocardiology, 19(3), 247-257. https://doi.org/10.1111/anec.12119
Xie, K., Cao, H., Ling, S., Zhong, J., Chen, H., Chen, P., Huang, R. (2025). Global, regional, and national burden of chronic kidney disease, 1990-2021: a systematic analysis for the global burden of disease study 2021. Frontiers Endocrinology, 16. https://doi.org/10.3389/fendo.2025.1526482
Yehia, H., Youssef, G., Gamil, M., Elsaeed, M., & Sadek, K. M. (2023). Electrocardiographic substrates of arrhythmias in patients with end-stage and chronic kidney diseases: a case-control study. The Egyptian heart journal (EHJ) : official bulletin of the Egyptian Society of Cardiology, 75(1), 13. https://doi.org/10.1186/s43044-023-00338-5
Zahra, A.S.A., & Simanjorang, C. (2024). Risk Factors of Chronic Kidney Disease in Indonesian Patients with Diabetes Mellitus. The Indonesian Journal of Public Health, 20(3), 102-111. https://doi.org/10.30597/mkmi.v20i3.33053
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