Korean J Nephrol.  2004 Mar;23(2):256-262.

Clinical Characteristics of Patients with Chronic Kidney Disease Associated with Marked Bradycardia

• Choi DH
• Ahn SH
• Jung SW
• Lee YM
• Kim HJ
• Lee MS
• Baek SH
• Song JH

Abstract

Since profound hyperkalemia induces fatal arrhythmias, the recognition of its electrocardiographic manifestations is very important. The changes on the ECG correlated roughly with the severity of hyperkalemia. It has been, however, less recognized that severe hyperkalemia is associated with bradycardia. We present 14 patients with chronic kidney disease manifesting marked bradycardia in the presence or absence of hyperkalemia. It is interesting that diabetes mellitus which was complicated in 10 of 14 patients in the present study might exaggerate bradycardia with or without hyperkalemia. 9 patients, who were taking drugs such as diltiazem, beta-blocker, alpha, beta-blocker, and digoxin, developed bradycardia even when their plasma potassium concentration were moderate (<6.5 mEq/L). Therefore, we suggest that synergistic action of these drugs, hyperkalemia, diabetes mellitus, and uremic toxin in patient with chronic kidney disease might play a role in inducing bradycardia.

Keyword

Bradycardia; Chronic kidney disease; Diabetic mellitus; Hyperkalemia

MeSH Terms

Arrhythmias, Cardiac
Bradycardia*
Diabetes Mellitus
Digoxin
Diltiazem
Electrocardiography
Humans
Hyperkalemia
Plasma
Potassium
Renal Insufficiency, Chronic*
Digoxin
Diltiazem
Potassium