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Abstract Introduction: Hyperkalemia is a common multifactorial condition of people on chronic dialysis and is associated with mortality. We aimed to inform and discuss the prevalence of hyperkalemia in a large population of chronic dialysis patients in Brazil and its geographic regions. Methods: Prevalence of hyperkalemia (serum potassium ≥6.0 mEq/L) was assessed in the Brazilian Dialysis Survey (BDS) in July 2019, an online survey of voluntary participation in which all dialysis centers registered at the Brazilian Society of Nephrology were invited. Results: Approximately one-third (n=263 of 805) of the Brazilian dialysis clinics participated. The prevalence of hyperkalemia in the whole population was 16.1% (n=7,457 of 46,193; 95%CI=15.8-16.5%,), and varied from 12.1% in the North to 18.7% in the Northeast. Conclusion: We found a high prevalence of hyperkalemia in a large Brazilian chronic dialysis population. A nationwide investigation of risk factors, treatment options, and whether this high prevalence contributes to dialysis mortality is warranted.
Resumo Introdução: A hipercalemia é uma condição multifatorial comum em pessoas em diálise crônica e está associada à mortalidade. Nosso objetivo foi informar e discutir a prevalência de hipercalemia em uma grande população de pacientes em diálise crônica no Brasil e diferenças entre as regiões geográficas. Métodos: A prevalência de hipercalemia (potássio sérico ≥6,0 mEq/L) foi avaliada por meio do Censo Brasileiro de Diálise (CBD) em Julho de 2019, uma pesquisa online de participação voluntária na qual foram convidados todos os centros de diálise registrados na Sociedade Brasileira de Nefrologia. Resultados: Aproximadamente um terço (n=263 de 805) das clínicas de diálise brasileiras participaram. A prevalência de hipercalemia na população total foi de 16,1% (n=7.457 de 46.193; IC95%=15,8-16,5%), e variou de 12,1% no Norte a 18,7% no Nordeste. Conclusão: Encontramos uma elevada prevalência de hipercalemia em umagrande população brasileira em diálise crônica. É necessária uma investigação nacional dos fatores de risco, opções de tratamento e se esta alta prevalência contribui para a mortalidade desta população.
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Background: Pre-analytical, analytical, or post analytical variations can induce, change, or alter the tests results. Laboratory errors lead to unnecessary delays in test report and also increased costs by repeat samples which have become a pain to the patients. Aims and Objectives: The aims of this study were to determine alterations in the concentration of serum sodium (Na+), potassium (K+), and ionized calcium (Ca++) concentration with reference to air exposure, time, temperature, and humidity. Materials and Methods: Fifty samples as case and 50 samples as control were included from a normal healthy population in this study. After getting the samples, first readings were taken for case samples and were uncapped and the remaining samples were set aside capped at 24°C, 20% humidity for half an hour and followed by second reading which was taken. Results: Variation in the mean serum sodium between groups is 0.06 mEq/L (0.04%) and 0.08 mEq/L (0.07%) which is very negligible and insignificant (P > 0.05). The mean level of serum K+ in cases is 4.35 mEq/L and in controls is 4.27 mEq/L. After half an hour, the mean level of serum K+ in cases is 4.51 mEq/L and, in controls, is 4.29 mEq/L. Hence, the variation in results in cases is 0.16 mEq/L (3.68%) and in controls is 0.02 mEq/L (0.47%) which is highly significant (P < 0.05). The mean level of serum Ca++ in cases is 1.15 mmol/L and in controls is 1.17 mmol/L. After half an hour, the mean level of serum Ca++ in cases is 1.09 mmol/L and in controls is 1.16 mmol/L. Hence, the variation in results in cases is 0.06 mmol/L (5.22%) and in controls is 0.01 mmol/L (0.85%) which is highly significant (P < 0.05). Conclusion: Air exposure significantly alters the serum K+ and Ca++ level, but the alteration in serum Na+ level is not significant.
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Background: Preeclampsia is a clinical condition in which the patient is suffering from hypertension and proteinuria, which may be associated with pathological edema. There are multiple systems involved in pre-eclampsia which is the main culprit to complicate the pregnancy. In developing nations, approximately 4–18% of pregnancies are complicated by preeclampsia which is a major cause of morbidity and mortality globally. It does not affect pregnant females only, but may be life-threatening for growing fetuses too. If we consider the mortality in all pregnant females, about 10–15% of maternal deaths are due to pre-eclampsia. Aims and Objectives: The main objective of this study is to compare the serum calcium, magnesium, sodium and potassium level in preeclampsia patients and normal pregnant women. Materials and Methods: After taking written consent from the patients, randomly 50 pregnant females diagnosed by a gynecologist as suffering from preeclampsia were selected and for the control group 50 pregnant females who came for routine checkups were selected. 5 ml of blood was collected in the clot activator tube. The samples were analyzed for serum calcium, magnesium, sodium, and potassium on a fully automated biochemistry analyzer ”Erba XL 640” in HiTech, clinical biochemistry laboratory, B.J medical college, Ahmedabad. Results: The result showed a decreased level of serum calcium, magnesium, sodium, and potassium in the study group compared to the control group. The S. calcium level was (7.624 ± 0.84) and (8.52 ± 0.80) mg/dl in the study and control groups respectively. The S. magnesium level in the study and control were (1.47 ± 0.25) and (1.79 ± 0.18) mg/dl, respectively. S. sodium levels were (131.46 ± 6.96) and (139.92±7.86) mEq/L in the study and control groups, respectively. And the level of S. potassium in the study and control groups was (3.39 ± 0.52) and (3.67 ± 0.38) mEq/L, respectively. All the parameter values are significantly lower in a study group in comparison to control group patients (P < 0.001). Conclusion: From our study, we have concluded that the serum level of some parameters such as calcium, magnesium, sodium, and potassium was significantly decreased in patients suffering from preeclampsia. We can also conclude that these parameters can be used as a biomarker for the diagnosis of preeclampsia.
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【Objective】 To investigate the correlation between D-dimer, serum potassium and thromboelastography parameters and progressive hemorrhagic injury (PHI) after brain injury. 【Methods】 The data of 209 patients with traumatic brain injury (TBI) in our hospital from January 2018 to May 2021 were collected and analyzed. The patients were divided into PHI group (161 cases) and non-PHI group (48 cases) according to CT scan whether the total bleeding lesions had increased by 25%. Univariate analysis and multivariate Logistic regression were used to analyze the risk factors of PHI, and receiver operating curve (ROC) was used to analyze the predictive value of D-dimer, serum potassium and thromboelastography (TEG) parameters used alone and in combination. 【Results】 PHI occurred in 48 (23.0 %) out of 209 TBI patients. In univariate analysis, there were statistically significant differences in GCS score, age, light emission, systolic blood pressure, serum potassium, blood calcium, blood glucose, R value, PT, APTT, INR, D-dimer, arachnoid hemorrhage, subdural hematoma, cerebral contusion and midline location between the two groups (P<0.05). Five independent risk factors were determined by multivariate Logistic analysis (P<0.05): D-dimer ≥3.52 μg/mL, serum potassium <3.70 mmol/L, R value ≥5.65 min, subdural hematoma and cerebral contusion. PHI model was constructed according to independent risk factors, and the maximum area under the curve (AUC) of D-dimer plus serum potassium plus R value plus subdural hematoma plus cerebral contusion was 0.889 9. 【Conclusion】 D-dimer ≥3.52 μg/mL, serum potassium <3.70 mmol/L, R value ≥5.65 min, subdural hematoma and cerebral contusion are significant influences for PHI occurrance in TBI patients.
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@#Introduction: Haemolytic specimens are a frequent occurrence in clinical laboratories, and they interfere with the analysis of many tests. Case report: We describe here an unusual case of leptospirosis complicated by haemolytic anaemia in a 70-year-old man with established kidney failure. He presented with an abrupt onset of shortness of breath, flushing and erythematous rash after completing haemodialysis. The patient’s biochemistry test samples were however rejected twice as they were grossly haemolysed. The integrated auto-verification alert system implemented in the hospital’s laboratory information system alerted the staff of the possibility of in vivo haemolysis. Discussion: The auto-verification alert system effectively distinguishes between in vitro and in vivo haemolysis and as such can be utilised as a diagnostic aid in patients with suspected intravascular haemolysis. Keywords:
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Background: Angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers (ARBs) are being used as first line agents for the treatment of hypertension in haemodialysis patients as well as in the general population. Serious hyperkalemia is common in patients with end-stage renal disease, and is observed in about 10% of haemodialysis patients. Although many research have been done so far to compare the antihypertensive efficacy of ARBs, but such studies to evaluate the effect on serum urea, creatinine and potassium levels are not so common in North India region.Methods: In this open label, prospective, randomized study, we evaluated the effect on serum urea, creatinine and potassium levels with use of ARB’s (olmesartan or telmisartan) in stage 1 hypertensive patients (JNCVII). 60 patients were randomized in to two groups. The odd numbers will be allotted olmesartan 20 mg (group A) and even numbers to telmisartan 40 mg (group B). Impacts on serum urea, creatinine and potassium levels were evaluated after 12 weeks.Results: Our results indicates that there was no statistically significant alterations in mean serum creatinine, blood urea and in mean serum potassium levels compared to baseline within the two groups as well as when mean of both groups were compared, olmesartan showed a better reduction in blood pressure as compared to telmisartan.Conclusions: Olmesartan showed a better reduction in blood pressure with similar effects in biochemical parameters as telmisartan.
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Background: Hypokalemic periodic paralysis (HPP) is a rare autosomal dominant channelopathy characterised by muscle weakness or paralysis when there is a fall of potassium level in the blood. In individuals with mutation, attack begins during adolescents and most commonly occurs after sleep on awakening, rest after strenuous exercise, high carbohydrate diet and meal with high sodium content. This study was conducted to analyse the age of incidence and prevalence of HPP with various clinical presentations, diagnosis and its effective treatment.Methods: A retrospective analysis of 50 patients of Hypokalemic periodic paralysis was analysed in tertiary care centre “Rajendra institute of medical science” Ranchi, Jharkhand, India, with reference to its clinical presentation, age of incidence and prevalence with laboratory parameters and treatment outcomes.Results: Incidence of attack is more common in men between 26-35 years of age. Sudden onset of flaccid quadriparesis was the most common presentation with history of high carbohydrate diet on the background of strenuous work during summer season. Around 60% had similar history of attacks in the past and most of the patients had serum potassium levels between 2.1-3.0mEq/L. Electrocardiography (ECG) abnormalities associated with hypokalemia had been observed in 90% of patients, and also significant clinical, biochemical changes have been observed as well.Conclusions: Early diagnosis not only helps in definitive management with potassium replacement, but also prevents patient going for life threatening respiratory failure. Patients recover completely without any clinical sequelae. Therefore, it is imperative for physicians, particularly those working in acute care settings, to be aware of this condition. Further management depends on the cause, frequency of attacks, severity of symptoms and the duration of the illness.
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Objective To explore whether serum potassium can influence insulin secretion ability in pa tients with impaired glucose regulation (IGR).Methods 320 subjects with IGR were enrolled in our study.All subjects underwent a standard OGTT.Their clinical and biochemical parameters were measured.Insulin secretion indices were measured by DI0,DI30,and DI120.Results In IGR,DI0 was negatively correlated with BMI (r=-0.122,P=0.015),total cholesterol (TC) (r=-0.182,P=0.032),low density lipoprotein-cholesterol (LDL-C) (r=-0.1 78,P=0.026) and triglyceride (TG) (r=-0.179,P=0.01 1).DI30 was negatively correlated with TC (r=-0.146,P=0.001),TG(r=-0.192,P=0.027)and LDL-C(r=-0.134,P=0.014).DI120 was negatively correlated with TC(r=-0.222,P＜ 0.001),TG(r=-0.209,P＜0.001)and LDL-C (r=-0.183,P＜0.001) while postively correlated with serum potassium (r=0.208,P＜0.001).The multiple regression model analysis showed that serum potassium (β=0.380,P＜0.001) was independently correlated to DI120.Conclusion In patients with IGR,serum potassium is associated with insulin secretion ability,which may provide a new treatment strategy for preventing IGR into T2DM.
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Introduction: Mean platelet volume (MPV) and Platelet Distribution Width (PDW) is a relatively simple, inexpensive tool that indicates the platelets size, the rate of platelet production, platelet activation and the severity of inflammation since inflammation plays an important role in COPD, any alteration in platelet activity can cause alteration in MPV. Red blood cell distribution width (RDW) reflects morphology of erythrocytes whereas RDW can also vary due to systemic inflammation and ineffective erythropoiesis. Hence we aimed to study Platelet indices in patients with exacerbation of COPD. Aim and objectives: Our aim is to evaluate the role of platelet Indices in COPD patients. Since only limited data were available on the relationship between COPD and platelet indices, we aimed to evaluate and find out the correlation between Mean Platelet Volume (MPV), Red Cell Distribution Width (RDW), Platelet Distribution Width (PDW) and Plateletcrit (PCT) in exacerbation of COPD patients at a tertiary care hospital in south India. Materials and methods: A total of 135 subjects, 79 men and 56 women, who were admitted in our hospital with exacerbation of COPD during a period of one year were enrolled in this prospective Ragulan R, Viswambhar V, Krishnaveni R, Meenakshi Narasimhan, Aruna Shanmuganathan, Nisha Ganga, Gangaiamaran M. Evaluation of platelet indices among patients with exacerbation of COPD in a tertiary care center in South India. IAIM, 2017; 4(7): 161-166. Page 162 observational study. The levels of MPW, RDW, PDW and PCT were assessed during the course of hospital stay in patients with COPD exacerbation Results: In our study we found out that there exists a statistical significance among male and female COPD exacerbation patients with respect to Mean Platelet Volume (P=<0.0001) and Red Cell Distribution Width (P=<0.0001). There also exists statistical significance between our COPD patients with other study stable controls (p=<0.005). Using ROC curve, considering optimal level of MPV <8.8Fl, male population showed sensitivity of 95% and specificity of 85% with Average age in men with diagnosed COPD is 49 and average age of female COPD patient is 55. Conclusion: Our study suggests that Mean Platelet Volume and Red Cell Distribution Width values may be useful for identifying patients who are at high risk for exacerbation of COPD. RDW per se is an important risk factor for Ischemic heart disease (IHD) and elevated RDW may suggest increase in risk of IHD in patients with COPD
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Objective To investigate vein pump injection of epinephrine on the effect of serum potassium during gastric cancer radical surgery. Method Forty patients with ASA grade Ⅱ~Ⅲ underwent surgery within a time limit of gastrointestinal under general anesthesia. All patients were randomly divided into the experimental group and the control group.Patients in the experimental group received continuous intravenous injections of adren-aline[0.03 to 0.1 μg/(kg·min)].Patients in the control group received equal dose of saline.Potassium concentra-tions at different time points were determined and compared between patients in two groups. Results No signifi-cant differences were observed in gender and age distribution of patients in the experimental group and the control group. Compared with the control group,potassium concentration was significantly decreased in patients at T3mo-ment(30 min pump injection of norepinephrine)(P<0.05),but was lower than that of patients in the experimen-tal group at T1moment(before anesthesia)(P<0.05).Compared with the control group,potassium concentration was significantly increased in the experimental group at T4moment(pump adrenaline injection for 10 min)(P <0.05),which was also significantly higher than that in the experimental group at T1moment(P < 0.05). Mean-while,compared with the control group,potassium concentration was also significantly increased in the experimen-tal group at T5moment(stop the pump adrenaline injection for 30 min),which was also significantly higher than that in the experimental group at T1moment(P < 0.05). Conclusions Intravenous injection of adrenaline can reduce potassium concentration in patients received gastrointestinal surgery,and potassium concentration can be increased after adrenalin injection was stopped.
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Objective To investigate the changes of vital signs, serum potassium and postoperative comfort of patients treated with MECT in the treatment of low-dose rocuronium.Methods 200 patients with MECT from June 2014 to June 2016 were selected and randomly divided into two groups, and the life signs and adverse reactions were analyzed and compared.Results There was no significant difference between the experimental group and the control group in the recovery time, the recovery time and the recovery time of the pharyngeal reflex.The recovery of spontaneous respiration in the experimental group was earlier than that in the control group, and the difference was statistically significant ( P<0.05 ) .There was no significant difference between the two groups (headache, drowsiness, postoperative irritability) compared with the control group, the incidence of muscle pain in the experimental group was significantly lower than that in the control group, the difference was statistically significant (P<0.05).Conclusion Pre-injection of rocuronium can reduce the level of serum potassium, shorten the recovery time of spontaneous breathing, and reduce the incidence of postoperative muscle soreness.Compared with the conventional MECT method, it can reduce the contraindication of MECT treatment and increase the comfort of patients.
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Background: The cardiovascular implications due to CO2 insufflation during laparoscopic surgeries have been a subject of research. Animal studies have reported life threatening increase in serum potassium levels during rise in intra-abdominal pressure. Methods: Induction of 30 patients undergoing laproscopic cholecystectomy was done by giving Thiopentone sodium 5 mg/kg and orotracheal intubation was facilitated by 0.1 mg/kg of vecuronium bromide. Blood samples for potassium were taken at pre-induction, pre insufflation, every 20 minutes during insufflations, immediate post exsufflation and immediately after extubation. Results: Serum potassium increased significantly (p<0.01) after insufflation of carbon dioxide (pre-induction 3.9 ± 0.3 vs. 4.5 ± 0.3 at 40 minutes of insufflation). The haemodynamics i.e blood pressure and pulse rate remained fairly (p>0.05) throughout the study period. Conclusion: Based on the findings of this study, we recommend that monitoring of serum potassium should be done in patients undergoing laparoscopic procedures of prolonged duration.
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Aim: The study was to analyze mean serum sodium and potassium levels in cataract patients and agematched individuals without cataract. Methods and Materials: It was a prospective case-control study. Individuals more than 50 years of age who attended our ophthalmic center in the year 2007-2010 were grouped into those having cataract and those without cataract. Mean serum sodium and potassium levels in the cataract groups were calculated and compared with the control group. Statistical software SPSS14 was used for statistical analysis. Results: Mean serum sodium levels in cataract group was 135.1 meqv/l and 133 meqv/l in the control group. Mean potassium was 3.96 meqv/l in the case study group and 3.97 meqv/l in controls. Mean sodium levels among cases were significantly higher than control group. No difference was seen in the PSC group and control. The difference in mean potassium among the two groups was statistically insignificant. Conclusion: Diets with high sodium contents are a risk factor for senile cataract formation and dietary modifications can possibly reduce the rate of progression cataract.
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OBJECTIVE: To study the effects of dimethyltin chloride( DMT) on the activity of renal H~+K~+-ATPase( HKA)and Na~+K~+-ATPase( NKA) in SD rats. METHODS: i) In vitro experiment. Five specific pathogen free( SPF) healthy female SD rats were used. The kidney homogenates made with 0. 90% sodium chloride solution was added with DMT( mass concentration,1. 0 g/L) to make final concentrations of 0,1,25,125 and 625 mg/L respectively,then the HKA and NKA activities were detected by the enzyme-linked immunosorbent assay( ELISA). ii) In vivo experiment. Forty SPF healthy SD rats were divided into control group and exposure group,with 20 rats( 10 males and 10 females) in each group. The exposure group was given one-time intraperitoneal injection with DMT( 16. 000 mg / kg body weight),while the control group was given one-time intraperitoneal injection with same volume of 0. 90% sodium chloride solution. The rats were executed 1 and 24 hours after exposure. The kidney tissue was extracted to make kidney homogenates for determination of HKA and NKA activity by microplate reader. The blood from abdominal aorta was collected to measure the levels of serum K~+,Na~+and Cl-. RESULTS: i) In vitro experiment. The HKA activity was inhibited by DMT,and the effect of inhibition increased with the increase of DMT exposure dose( P < 0. 01),showing a dose-effect relationship. The DMT had no effect on NKA activity( P > 0. 05). ii) In vivo experiment. The body weight of rats at 24 hours time point in exposed group was lower than that in control group( P < 0. 01). The HKA activity of the kidney tissue in rats in exposed group was lower than that of control group( P < 0. 01). The NKA activity in kidney tissue of rats and the level serum K~+,Na~+and Cl-did not show statistical difference in main and interactive effects concerning treatment and exposure time( P > 0. 05). CONCLUSION: DMT could inhibit the HKA activity in kidney homogenates,but had no obvious effect on NKA activity.
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Objective To observe the changes of serum potassium concentration in rectal cancer patients from the admission to before the operation,to provide clinical evidence for preventing serum potassium disorder during and after their operation.Methods Monitoring of the changes of serum potassium concentration of 40 cases of rectal cancer patients according to three time points including the first day of admission,before taking of cathartics and the morning before operation.They were divided into different groups according to their age(young,middle age and elderly group),gender(male and female group),diet(normal,decreased slightly and serious decline group) and course(long,middle and short course group) of disease.The serum potassium concentration was observed between each time point of each group and SPSS13.0 statistical software was used to analyze the changes above.Results The mean of all patients' serum potassium concentration was (4.09 ± 0.62) mmol/L on the first day of admission,was (3.83 ± 0.46) mmoL/L before taking of cathartics that was decreased compared to the former and there was significant difference (P ＜ 0.01),it was (3.36 ±0.40) mmol/L on the morning of operation and had significant difference with the above two groups (P ＜ 0.01).It hadn't significant difference between different gender and age groups at different time points (P ＞ 0.05) except between the young group and the elderly group in the morning of the operation (P ＜ 0.05).There were statistically significant differences between the different diet condition and different course at anytime point (P ＜ 0.01).Conclusions The rectal cancer patients were possiblely in hypokalemia before operation,the causes might be relative to the long course of disease,the decreased diet,the aged and infirm,the diet structure change after admission and taking cathartics cleaning intestinal tract.
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Objective To determine the association between serum potassium level and the severity of coronary artery atherosclerosis. Methods A total of 246 patients underwent coronary artery angiography were included into this study, and were divided into four groups according to the involved main coronary artery:control group (0 diseased vessel, n=81), one dis?eased vessel group (n=43), double diseased vessel group (n=46) and three diseased vessel group (n=76). Patients were also di?vided into low potassium group (K+double diseased vessel group>one diseased vessel group>control group (P<0.05). (2) There was a significantly higher Gensini score in low potassium group [36(8, 94)] than that of high potassium group [16(0,56)]. (3) There was significant negative correlation between serum potassium level and Gensini score (r=-0.206, P=0.001). (4) It was found that age, male, the low level of serum potassium, diabetes mellitus and hyperten?sion were independent risk factors of CHD. Conclusion The serum potassium level is negatively correlated with the severi?ty of CHD. The low level of serum potassium is an independent risk factor of CHD.
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Objective To assess the effectiveness of the quotient of serum sodium to urinary sodium divided by (serum potassium) 2 to urinary potassium (SUSPPUP) in screening for primary aldosteronism (PA).Methods Among 952 patients with hypertension who had renin activity,aldosterone measurements and concomitant serum and urinary biochemistry data,204 patients were diagnosed as cases of PA and 261 as cases of essential hypertension.Diagnosis of PA was made in accordance with established laboratory criteria including renin activity and aldosterone,plasma aldosterone concentration/plasma renin activity (ARR),and saline loading test.The SUSPPUP ratio with the ARR were compared in two groups.Results The area under the curve of SUSPPUP and ARR was 0.797 and 0.796 respectively according to receiver operating characteristic curve,optimal cutoff of SUSPPUP was 1.0,the sensitivity and specificity of SUSPPUP was 98.9％ and 81％ respectively.Conclusions The SUSPPUP ratio is an inexpensive and rapid tool to assess the extent of mineralocorticoid excess,therefore,SUSPPUP ratio can be applied to screen PA in hypertensive patients.
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Objetivo: determinar si a la hipercaliemia prolongada en pacientes en hemodiálisis con enfermedad renal crónica (ERC) contribuye en valor significativo la presencia de pseudohipercaliemia (diferencia entre potasio sérico a plasmático mayor a 0.5 mEq/L) Pacientes: aquellos con ERC en terapia hemodialítica por más de 12 meses de evolución en quienes se detectara hipercaliemia persistente por más de tres meses. Material y métodos: determinación simultánea de potasio sérico y plasmático, y adicionalmente las variables sodio sérico, gases arteriales, cuadro hemático completo, glucemia en ayunas, Kt/v y electrocardiograma Resultados: en 110 pacientes evaluados 17 cumplieron los criterios de inclusión, en ellos en 13 (76.47%) se detectó pseudohipercaliemia y en 4 (23.52%) hipercaliemia verdadera (diferencia entre potasio sérico a plasmático menor a 0.5 mEq/L). No se detectaron diferencias significativas entre grupos en las variables analizadas Conclusión: la pseudohipercaliemia representa un porcentaje muy importante del reporte de hipercaliemias en pacientes con ERC en terapia hemodialítica, y lo ideal en ellos es siempre determinar potasio plasmático. (Acta Med Colomb 2013; 38: 12-15).
Objective: determine if to prolonged hyperkalemia in hemodialysis patients with chronic kidney disease (CKD) contributes significantly the presence of pseudohyperkalemia (difference between serum to plasma potassium greater than 0.5 mEq/L) Patients: those with CKD on hemodialysis therapy for more than 12 months duration in whom persistent hyperkalemia is detected for more than three months. Materials and methods: simultaneous determination of serum and plasma potassium and in addition the variables serum sodium, arterial blood gases, complete blood count, fasting blood glucose, Kt / v and electrocardiogram Results: in 110 patients evaluated 17 met the inclusion criteria. In 13 of them (76.47%) we detected pseudohyperkalemia and in 4 (23.52%) true hyperkalemia (difference between serum to plasma potasium less than 0.5 mEq / L ). No significant differences between groups in the variables analyzed were detected. Conclusion: the pseudohyperkalemia represents a very important percentage of the report of hiperkalemias in CKD patients on hemodialysis therapy, and ideally plasma potasium has to be determined always in these patients. (Acta Med Colomb 2013; 38: 12-15).
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Humanos , Femenino , Persona de Mediana Edad , Hiperpotasemia , Plasma , Potasio , Recuento de Células Sanguíneas , Insuficiencia Renal CrónicaRESUMEN
OBJECTIVE: To evaluate the accuracy of potassium concentrations measured by blood gas analysis (PBG) compared with laboratory serum potassium (LSP), in the initial care of patients with diabetic ketoacidosis (DKA). SUBJECTS AND METHODS: Fifty three patients with diabetes mellitus were evaluated in a retrospective analysis. PBG was carried out using the Radiometer ABL 700 (Radiometer Copenhagen®), and results were compared with LSP ADVIA 1650 Chemistry system (Siemens®), the gold standard method. Both methods are based on potentiometry. RESULTS: Mean PBG was 3.66 mmol/L and mean LSP was 4.79 mmol/L. Mean difference between PBG and LSP was -1.13 mmol/L (p < 0.0005, 95 percent CI, -1.39 to -0,86). Lin concordance correlation coefficient was rc = 0.28 (95 percent CIb, 0.10 to 0.45), demonstrating low concordance between the methods. CONCLUSION: Although PBG measurement is faster and easier, it should not be used as a surrogate for LSP in the clinical treatment of DKA.
OBJETIVO: Avaliar a acurácia da mensuração da concentração de potássio realizado nos analisa-dores de gasometria sanguínea (PGS) em relação ao potássio plasmático laboratorial (PPL) no atendimento inicial dos pacientes com cetoacidose diabética (CAD). SUJEITOS E MÉTODOS: Foram avaliados, retrospectivamente, 53 pacientes com diabetes melito e CAD. A análise do PGS foi realizada pelo equipamento ABL 700 (Radiometer Copenhagen®), sendo este comparado ao método padrão-ouro de PPL ADVIA 1650 (Siemens®), ambos por potenciometria. RESULTADOS: A média do PGS foi de 3,66 mmol/L e do PPL, de 4,79 mmol/L. A diferença das médias do PGS em relação ao PPL foi de -1,13 mmol/L (p < 0,0005, IC = 95 por cento; -1,39 a -0,86). O coeficiente de concordância de Lin foi de rc = 0,28 (ICb = 95 por cento; 0,10 a 0,45), demonstrando, assim, uma baixa concordância entre os métodos. CONCLUSÃO: Apesar de a realização do PGS ser tecnicamente mais rápida e fácil, não deve ser usada como parâmetro substituto ao PPL para o tratamento clínico da CAD.
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Adolescente , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Adulto Joven , Cetoacidosis Diabética/sangre , Potasio/sangre , Análisis de los Gases de la Sangre/efectos adversos , Análisis de los Gases de la Sangre/métodos , Recolección de Muestras de Sangre/efectos adversos , Recolección de Muestras de Sangre/métodos , Potenciometría/métodos , Estudios RetrospectivosRESUMEN
Objective. To study electrolyte status in asphyxiated newborns of different severity in early neonatal period and compare with controls. Methods. Sodium, potassium and total calcium levels were estimated in the serum samples of asphyxiated newborns of different severity and control group immediately after birth. Results. Mean serum sodium level was significantly lower (122.1 ± 6.0 mEq/L vs 138.8 ± 2.7 mEq/L; P < 0.001), mean serum potassium was higher (5.05 ± 0.63 mEq/L vs 4.19 ± 0.40 mEq/L; P < 0.001) and mean serum calcium level was found lower (6.85 ± 0.95 mg/dl vs 9.50 ± 0.51 mg/dl; P < 0.001) in cases than controls. Among cases, a strong positive linear correlation was found between the serum sodium, serum calcium levels and their Apgar scores, between sodium levels and total calcium levels and significant negative linear correlation between Apgar scores and serum potassium level. Conclusion. Among cases, hyponatremia and hypocalcemia developed early and simultaneously and the decrease in their serum levels was directly proportional to each other and to the degree of asphyxia. Though, mean potassium level was within the normal limit, the value was higher among cases than controls and directly proportional to asphyxia.