In hemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD) patients, an independent predictor of all-cause and cardiovascular (CV) mortality is fragmented QRS complex (fQRS) presence. Findings indicate a potential role of the fQRS complex in CV risk strata for dialysis cases and the selection of dialysis modality.

• In this prospective observational study, a total of 411 patients receiving HD or CAPD between 2016-01-01 and 2020-12-31 were included.

• Increased values of fQRS complex were found in HD patients vs CAPD patients (39.1% vs 28.2%).

• Significantly, fQRS complex in the anterior/lateral leads was identified to be linked with all-cause and CV mortality stronger than fQRS in the inferior leads.

• A higher incidence of all-cause mortality (hazard ratio [HR] = 1.860) and CV mortality (HR = 2.989) was present in HD patients with fQRS complex, in a multivariate Cox regression analysis.

• Increased risk of all-cause mortality (HR = 1.593) and elevated risk of CV mortality (HR = 2.392) were observed in relation to fQRS complex in CAPD patients.