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Nephrol Dial Transplant (2000) 15: 1814-1818
© 2000 European Renal Association-European Dialysis and Transplant Association

Retrospective analysis of cisapride-induced QT changes in end-stage renal disease patients

Melissa J. Hentges1, Brent W. Gunderson2 and Matthew J. Lewis3,

1 Division of Nephrology, Hennepin County Medical Center, 2 University of Minnesota College of Pharmacy, 3 Division of Nephrology, Hennepin County Medical Center, Minneapolis, Minnesota, USA

Background. This study involves a retrospective in-patient chart review of end-stage renal disease (ESRD) patients receiving haemodialysis to observe if cisapride significantly increases heart rate (HR), QT, and corrected QT (QTc) intervals on 12-lead electrocardiograms (ECGs).

Methods. Medical records for 23 patients who were being treated with chronic maintenance haemodialysis and had >=2 ECGs while on cisapride and >=2 ECGs while off cisapride were obtained and reviewed. HR, QT, and QTc on all 12-lead ECGs, reason for admission, and past medical history were analysed.

Results. A total of 529 ECGs (279 on/250 off cisapride) for 23 patients were included. The results, as calculated by each patient's individual averages (n=23), on vs off cisapride respectively, were HR, 88±14 vs 84±17 beats/min (P=0.18); QT, 373±39 vs 382±45 ms (P=0.24); and QTc, 443±27 vs 441±21 ms (P=0.39). No significant difference was found in the number of admissions per month while on or off cisapride. No patient had an average QTc on or off cisapride that was >500 ms. One patient died from ventricular arrhythmia 12 days after discontinuing cisapride. The patient's QTc was significantly longer on vs off cisapride (487 vs 462 ms, P=0.007); however, this patient had an extensive cardiac history and multiple syncopal episodes prior to the use of cisapride.

Conclusions. This study found no significant overall difference in HR, QT, and QTc interval or admissions/month on vs off cisapride in ESRD patients receiving haemodialysis.

Keywords: cisapride; end-stage renal disease; haemodialysis; QT interval; QTc interval

Correspondence and offprint requests to: Matthew J. Lewis PharmD BCPS, Division of Nephrology (D5), Hennepin County Medical Center, 914 South 8th Street, Minneapolis, MN 55404, USA.


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