Renal tubular acidosis electrocardiogram

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Aditya Ganti M.B.B.S. [2]

Electrocardiogram findings associated with renal tubular acidosis include changes due to potassium levels. Peaked T waves are the earliest sign of hyperkalemia. where as hypokalemia presents with ST segment depression, decreased T wave amplitude, and prominent U waves.

Electrocardiogram changes in renal tubular acidosis is associated with potassium changes.

EKG findings of hyperkalemia associated with renal tubular acidosis include:

• Peaked T Waves
  • Peaked T waves are the earliest sign of hyperkalemia.

• Interventricular Conduction Delay
  • It is observed when K > 6.5 meq/L
  • Interventricular conduction delay is reflected by QRS widening that are inconsistent with LBBB or RBBB.

• Loss of P Waves^[1][2]

• Sinus Arrest with Accelerated Junctional Rhythm^[3][4][2]

• Sine Wave Pattern^[1][2]

• Ventricular fibrillation

EKG findings of hypokalemia associated with renal tubular acidosis include:

• ST segment depression, decreased T wave amplitude, and prominent U waves
• Prolongation of the QRS duration
• Increase in the amplitude and duration of the P-wave
• Cardiac arrhythmias and AV block
• Contrary to popular belief there is not prolongation of the QTc, this is artifactually prolonged due to the U wave. In some cases there is fusion of the T and U waves making interpretation impossible.
• Ventricular ectopy
  • Premature ventricular complex
  • Ventricular tachycardia
  • Ventricular fibrillation