Evaluation of QTc Interval Pre- and Post-Albumin Administration in Pediatric Nephrotic Syndrome Patients with Hypocalcemia

Document Type : original article

Authors

1 Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

2 Department of Pediatric Cardiology, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.

3 Department of Community Medicine, Faculty of Medicine, Islamic Azad University of Mashhad, Mashhad, Iran.

4 Kidney Transplantation Complications Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.

Abstract

Background: Nephrotic syndrome (NS) in children is characterized by heavy proteinuria, hypoalbuminemia, and edema. Hypocalcemia, commonly resulting from urinary loss of albumin-bound calcium, can prolong the QT interval, increasing the risk of ventricular arrhythmias. This study aimed to evaluate the effect of albumin administration on the corrected QT (QTc) interval in pediatric NS patients
Methods: A cross-sectional study was conducted on 20 children with NS and hypoalbuminemia who received albumin infusions. Baseline electrocardiograms (ECGs) and serum parameters, including albumin and electrolyte levels, were recorded before and after albumin infusion. QTc intervals were calculated using Bazett’s formula. The Wilcoxon signed-rank test was used to assess changes in QTc before and after infusion.
Results: The study included 20 children with NS (15 males, 5 females; mean age 6 ± 4 years). The mean serum albumin level was 2 ± 0 g/dL, indicating significant hypoalbuminemia. Hypocalcemia was present in 79% of patients and was associated with higher QTc intervals. The mean QTc decreased from 411 ± 45 ms pre-infusion to 401 ± 44 ms post-infusion, showing a statistically significant reduction (p < 0.001), particularly in patients with hypocalcemia.
Conclusion: Albumin administration significantly reduces QTc intervals in children with NS, especially those with hypocalcemia, potentially lowering the risk of arrhythmias. Further research is warranted to evaluate the long-term cardiac effects of albumin therapy in this population.

Keywords

References

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Journal of Pediatric Perspectives
Volume 13, Issue 6
June 2025
Pages 19508-19515

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