Association of electrocardiographic QRST angle with chronic kidney disease among middle aged and elderly rural residents

Objective To explore the association between electrocardiographic QRST angle and chronic kidney disease (CKD) in middle aged and elderly rural populations.

Methods We conducted a cross-sectional survey, including questionnaire interview, physical examination, and electrocardiogram and blood tests, among 4 258 rural residents aged 40 years and older recruited with cluster sampling in 16 villages of Chaoyang municipality, Liaoning province in September 2017. The estimated glomerular filtration (eGFR) of the participants was calculated with CDK-epidemiology collaboration (CDK-EPI) formula and the participants with the eGFR of < 60 ml/minute/1.73 m² CDK were considered as with renal insufficiency. The plane QRST angle was obtained with a 12-lead electrocardiogram (ECG), and the cut-off point of QRST angle is 95% quintile (79°) and the values greater than 79° were judged as abnormal QRST angle. The correlation between CDK and QRST angle was assessed with logistic regression analysis.

Results Of all the participants, 69 (1.62%) were identified with CKD. A significant greater QRST angle was observed among the participants with CKD than among those without CDK (26° vs. 18°, P < 0.05). Abnormal QRST angle was a independent risk factor for CDK after adjusting for serum potassium, triglyceride, high-density lipoprotein cholesterol, systolic blood pressure, heart rate, smoking, waist circumference, hemoglobin, and cerebral infarction (odds ratio = 2.32, 95% confidence interval: 1.06 – 5.04).

Conclusion Increased electrocardiographic QRST angle is significantly associated with chronic kidney disease in general population and plane QRST angle could be used as a predicator for the process of chronic kidney disease.