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Abstract
Cardiovascular mortality is very high in chronic and end-stage kidney disease (ESKD).
However, risk stratification data are lacking. Sudden cardiac deaths are among the
most common cardiovascular causes of death in these populations. As a result, many
studies have assessed the prognostic potential of various electrocardiographic parameters
in the renal population. Recent data from studies of implantable loop recordings in
haemodialysis patients from five different countries have shed light on a pre-eminent
bradyarrhythmic risk of mortality. Importantly, heart block addressed by permanent
pacing system was detected in a proportion of patients during the prolonged recording
periods. Standard electrocardiogram is inexpensive, non-invasive and easily accessible.
Hence, risk prediction models using this simple investigation tool could easily translate
into clinical practice. We believe that electrocardiographic assessment is currently
under-valued in renal populations. For this review, we identified studies from the
preceding 10 years that assessed the use of conventional and novel electrocardiographic
biomarkers as risk predictors in chronic and ESKD. The review indicates that conventional
electrocardiographic markers are not reliable for risk stratification in the renal
populations. Novel parameters have shown promising results in smaller studies, but
further validation in larger populations is required.