The Potential of Electrocardiography for Cardiac Risk Prediction in Chronic and End-stage Kidney Disease

Sofia Skampardoni; Dimitrios Poulikakos; Marek Malik; Darren Green; Philip A. Kalra


Nephrol Dial Transplant. 2019;34(7):1089-1098. 

In This Article

Review Methodology

Data Sources and Search Strategy

MEDLINE through PubMed, Google Scholar and Cochrane Library were searched to identify potentially relevant articles and abstracts. Furthermore, we reviewed the bibliographies of the selected articles for additional relevant studies. The search terms are presented in Table 1.

Eligibility of Studies

Studies in any of the CKD, HD and peritoneal dialysis (PD) populations were considered for inclusion if they met the following criteria: published between January 2007 and December 2016; investigated at least 50 participants in the initial cohort; had a mean follow-up time of at least 1 year; any external, non-invasive ECG methodology (standard 12-lead, Holter, etc.); assessed death and/or cardiac outcomes as an endpoint; studied the association of left ventricular hypertrophy (LVH), QTc interval, QRS complex, PR interval, QRS–T angle and/or heart rate variability (HRV) with these endpoints.

Figure 1 shows a schematic representation of the different components of a standard ECG in sinus rhythm. Figure 2 shows a representation of QRS–T angle from vectorcardiograms.

Figure 1.

Schematic diagram of ECG (sinus rhythm).

Figure 2.

A representation of QRS–T angle from vectorcardiograms.

Cardiac outcomes included coronary events, arrhythmic events, cardiac failure or a combination of these. Death included all-cause mortality and, where available, sudden death as defined by the authors.

Studies are presented in two categories, one for dialysis and the other for CKD. Due to the paucity of studies including PD patients, studies in PD and HD are not listed separately.