# Prognostic Significance of Prolonged QTc Interval in Patients on Dialysis: A Retrospective Cohort Study

## TL;DR

Prolonged QTc interval in dialysis patients is linked to higher risks of heart problems and death.

## Contribution

This study identifies prolonged QTc as an independent predictor of adverse outcomes in dialysis patients.

## Key findings

- Prolonged QTc increases all-cause mortality risk by 67%.
- It raises the risk of cardiac arrest and ventricular arrhythmia significantly.
- New-onset atrial fibrillation and heart attack risks are also elevated.

## Abstract

Prolonged QT interval is common in end‐stage renal disease (ESRD) on dialysis, but its long‐term cardiovascular (CV) implications remain unclear.

Using TriNetX network (2010–2024), we identified adults with ESRD on dialysis and categorized them by QTc status. After 1:1 propensity score matching (n = 3428/group), outcomes (hazard ratio [HR]) were assessed using Cox regression.

Prolonged QTc (> 500 ms) was associated with higher risk of all‐cause mortality (HR 1.67; p < 0.001), MACEs (HR 1.40; p < 0.001), cardiac arrest (HR 1.75; p < 0.001), sustained ventricular arrhythmia (HR 1.66; p < 0.001), new‐onset atrial fibrillation (HR 1.12; p = 0.01), and acute myocardial infarction (HR 2.19; p < 0.001).

In ESRD patients on dialysis, prolonged QT interval was independently associated with adverse CV outcomes and mortality.

Prognostic Significance of Prolonged QTc Interval in Patients on Dialysis