Electrocardiographic monitoring in children with chronic renal failure

Continuous electrocardiographic (ECG) monitoring was performed over 24 h in 44 children at various stages of chronic renal failure in order to determine the incidence and nature of cardiac dysrhythmias. In addition the ECG was followed during haemodialysis sessions and during dialysate exchanges in continuous ambulatory peritoneal dialysis (CAPD) patients. In contrast to adult patients on haemodialysis life-threatening dysrhythmias were not observed. The proportion of children with premature ventricular complexes (41%) was at the upper limit of that in healthy children. A relatively high heart rate was found in children on CAPD, which varied during the exchange procedure. In 57% of all patients a transient marked prolongation of the QT interval up to 40% greater than normal was observed without obvious changes in the serum electrolyte levels. Continuous ECG monitoring is a useful tool for detecting alterations of cardiac rhythm and conduction in at-risk children with renal failure.