Long-term changes in QT interval in hemodialysis patients

Cardiovascular disease, particularly sudden cardiac death, remains a major challenge in dialysis patients whose hearts experience ongoing structural, electrophysiological, and neurohormonal stress. Among these alterations, QT interval prolongation-reflecting an imbalance in autonomic regulation-is closely associated with arrhythmic risk. Yet, its long-term trajectory in hemodialysis patients has not been systematically examined. In this study, we evaluated heart rate-corrected QT (QTc) intervals at 1, 4, 7, and 10 years after hemodialysis (HD) initiation in 80 patients. ECGs were obtained immediately before HD sessions, and QTc was calculated using the Bazett formula. Although an overall increasing trend was observed, a statistically significant prolongation was detected only at 10 years by Dunnett-type multiple comparison. These findings provide new insight into the gradual nature of QTc progression in HD patients and may contribute to improved cardiovascular risk stratification in clinical practice.