Retrospective analysis of the effects of cisapride on the QT interval and QT dispersion in chronic hemodialysis patients.

Item request has been placed! ×
Item request cannot be made. ×
loading   Processing Request
Read More Add to Saved list
  • Author(s): Mathis AS;Mathis AS; Costeas C; Barone JA
  • Source:
    American journal of kidney diseases : the official journal of the National Kidney Foundation [Am J Kidney Dis] 2001 Dec; Vol. 38 (6), pp. 1284-91.
  • Publication Type:
    Journal Article
  • Language:
    English
  • Additional Information
    • Source:
      Publisher: W.B. Saunders Country of Publication: United States NLM ID: 8110075 Publication Model: Print Cited Medium: Internet ISSN: 1523-6838 (Electronic) Linking ISSN: 02726386 NLM ISO Abbreviation: Am J Kidney Dis Subsets: MEDLINE
    • Publication Information:
      Publication: Philadelphia Pa : W.B. Saunders
      Original Publication: New York, N.Y. : Grune & Stratton, c1981-
    • Subject Terms:
      Cisapride* ; Gastrointestinal Agents* ; Renal Dialysis*; Electrocardiography/*drug effects ; Gastrointestinal Diseases/*drug therapy ; Kidney Failure, Chronic/*complications; Arrhythmias, Cardiac/chemically induced ; Arrhythmias, Cardiac/diagnosis ; Contraindications ; Drug Interactions ; Female ; Gastrointestinal Diseases/etiology ; Humans ; Kidney Failure, Chronic/therapy ; Male ; Middle Aged ; Potassium/blood ; Retrospective Studies
    • Abstract:
      Cisapride is contraindicated in patients with end-stage renal disease (ESRD) and gastrointestinal motility disorders. Ventricular arrhythmias have been associated with both cisapride and hemodialysis (HD). However, reports conflict regarding the safety of cisapride in HD patients. We undertook this study to characterize the effects of cisapride on QT intervals and QT dispersion (QTD) in HD patients. Baseline and steady-state electrocardiograms (ECGs) were retrospectively selected for calendar year 1999 for each patient administered cisapride if ECGs showed sinus rhythm, potassium level was 3.5 mEq/dL or greater, and there was no pharmacokinetic drug interaction. QT intervals were measured by two investigators, and QTDs were calculated (maximum [QT(max)] - minimum QT interval [QT(min)]). Averages between investigator measures (+/- SD), presented for each value, were evaluated using Wilcoxon's signed-rank test. Thirty-one HD patients were administered cisapride. Seventeen patients failed to meet entry criteria, and no patient had a pharmacokinetic drug interaction. In included patients (6 men, 8 women), heart rates were 86.71 +/- 20.87 beats/min at baseline and 86.57 +/- 14.23 beats/min during treatment (P = not significant). Serum potassium levels were 4.97 +/- 1.2 mEq/dL at baseline and 4.94 +/- 0.76 mEq/dL during treatment (P = not significant). Average baseline QT(max) and QT(min) were 391.07 +/- 42.43 and 330.71 +/- 40.94 milliseconds, respectively. Treatment QT(max) and QT(min) were 391.43 +/- 38.2 and 343.93 +/- 35.69 milliseconds, respectively (P = not significant for both). QTD was 60.36 +/- 17.59 milliseconds at baseline and 47.5 +/- 19.59 milliseconds during treatment (P = 0.074). Mean corrected QT (QTc) intervals increased from 426.57 +/- 26.62 to 431.71 +/- 29.98 milliseconds (P = 0.55) from baseline to treatment. No ventricular arrhythmia was observed during at least 160 days (range, 2 to 830 days) of cisapride exposure. Two patients died during this study, both of other causes 4 days after discontinuing cisapride therapy. Cisapride did not significantly increase mean QTc interval, QT(max), or QTD in patients with ESRD managed by HD when potassium levels were stable and pharmacokinetic drug interactions were avoided.
    • Accession Number:
      0 (Gastrointestinal Agents)
      RWP5GA015D (Potassium)
      UVL329170W (Cisapride)
    • Publication Date:
      Date Created: 20011201 Date Completed: 20011213 Latest Revision: 20171116
    • Publication Date:
      20240829
    • Accession Number:
      10.1053/ajkd.2001.29226
    • Accession Number:
      11728962