[End stage renal disease and ventricular arrhythmia. Hemodialysis and hemodiafiltration differently affect ventricular repolarization]. / Végstádiumú vesebetegség és kamrai szívritmuszavarok. A hemodialízis és a hemodiafiltráció a kamrai repolarizációt eltéroen befolyásolja.

ABSTRACT

Various factors (hypertension [27%], diabetes mellitus [40%]) and their cardiovascular complications play an important role in the genesis of end stage renal disease. Furthermore, primary kidney diseases (glomerulonephritis, tubulointerstitial nephritis, obstructive uropathy, analgesic nephropathy, polycystic kidney disease, autoimmune diseases) have an unfavorable effect on the cardiovascular outcome of this particular population. Increased susceptibility for arrhythmias may be caused by intermittent volume overload, metabolic disturbance, renal anemia, structural and electrophysiological changes of the myocardium, inflammatory mechanisms that may worsen the mortality statistics of these patients. A novel renal replacement method, hemodiafiltration - based on a convective transport - ensures reduced mortality that may be attributed to a decreased occurrence of arrhythmias. The aim of this paper is to review the pathogenetic factors taking part in the arrhythmogenesis of end stage renal disease and to provide diagnostic and therapeutic opportunities that can help in the prediction and prevention of arrhythmias.