جستجوی مقالات مرتبط با کلیدواژه "electrolyte disorders" در نشریات گروه "پزشکی"

Electrolyte disorders, particularly hyponatremia, have been reported in a considerable number of patients with Coronavirus Disease 2019 (COVID-19).

The current study aims to evaluate the risk factors, symptoms, and prognosis of hyponatremia in hospitalized patients with COVID-19.

In this retrospective cohort study, 467 patients with COVID-19 were divided into 4 groups based on the sodium level at the time of admission: normal, mild hyponatremia, moderate hyponatremia, and severe hyponatremia. Symptoms, laboratory findings, and prognosis were compared among these groups. The risk factors for the occurrence of moderate/severe hyponatremia and the association of hyponatremia with in-hospital mortality were investigated using logistic regression analysis.

Hyponatremia was diagnosed in 60% of the patients. The prevalence of mild, moderate, and severe hyponatremia was 80.7%, 15.1%, and 4.2%, respectively. The severity of the clinical symptoms and level of hypoxia showed no significant difference between the groups. White blood cells count was significantly higher and lymphocyte percentage was significantly lower in hyponatremia groups compared to the normal group. The history of chronic kidney disease was an independent risk factor for the moderate/severe hyponatremia (Adjusted OR=5.11, 95%CI: 1.72-15.2, P=0.003). After adjustment of different risk factors, moderate/severe hyponatremia remained a significant independent risk factor for in-hospital mortality (OR=2.58, 95%CI: 1.13-5.88, P=0.024).

Hyponatremia is prevalent in COVID-19 patients. However, it is not definitely associated with severity of COVID-19 at the time of admission. Moderate/severe hyponatremia is associated with higher in-hospital mortality rate despite the similarity of disease severity between the sodium groups.

There is little consensus about type of the maintenance fluid therapy and it’s effect on serum sodium in adults. Thus, this study was conducted to assess the effect of maintenance fluid therapy on serum sodium of hospitalized patients in intensive care unit. This randomized clinical trial was carried out on 64 patients aged 18-90 years hospitalized in intensive care unit (ICU) of Imam Sadjad and Shahid Beheshti hospitals, Yasuj, Iran in 2017. These patients were randomly allocated to take 2500-3000 milliliter of intravenous maintenance isotonic (0.9% saline) or hypotonic (0.45% saline) fluids daily. Blood and urine samples were taken to measure biochemical parameters before and 48 hours after intervention.  Data analyses were done by using SPSS 16 software via descriptive and analytic statistics. Twenty eight patients in 0.9% saline group (19 male and 9 female) and 32 patients in 0.45% saline (20 male and 12 female) completed the study. There was no significant difference between two groups in sodium (P=0.94), potassium (P=0.21), sugar (P=0.91), creatinine (P=0.21), Blood Urea Nitrogen (P=0.99), systolic (P=0.81) and diastolic (P=0.73) blood pressure, PH(P=0.27), bicarbonate(P=0.8), and urine specific gravity(P=0.73). Based on the results of this study, it was shown that administration of maintenance hypotonic fluids has been appropriate for the patients and will not face them with the risk of hyponautremia.

Increased serum creatinine level and decreased glomerular filtration rate are the major features of vancomycin nephrotoxicity. Electrolyte disorders of this agent have not been considered in relevant clinical studies so far. The aim of the present study was to determine potassium and magnesium disorders in patients with hematologic and oncologic diseases under vancomycin treatment. A cross-sectional, observational study was performed during 9 months at three hematology-oncology wards of Namazi hospital in Shiraz. Patients > 18 years with no documented history of acute kidney injury or chronic kidney disease planned to receive vancomycin for at least 1 week were recruited. Urine samples for determining creatinine, potassium, and magnesium levels were collected at days 0, 3, 5, 7, 10, and 14 of treatment. Hypokalemia and hypomagnesemia was defined as serum potassium and magnesium level below 3 mEq/L and 1.2 mEq/L, respectively. Two-fifth (40.38%) of the study population developed hypokalemia during 2 to 3 days after initiating vancomycin. Hypomagnesemia was detected in 5.77% of vancomycin recipients with the time onset of 7.67 ± 3.21 days. The mean ± standard deviation of potassium supplement was significantly higher in patients with than those without hypokalemia (P = 0.006). No case of renal potassium and magnesium wasting was identified. Amphotericin b co-administration significantly associated with hypokalemia during vancomycin treatment (odds ratio = 0.164 [95% confidence interval = 0.041-0.647], P = 0.01). In contrast to hypomagnesemia, hypokalemia occurred commonly during the first days of vancomycin treatment. However, the real casual relationship, mechanism, and clinical outcome of these electrolyte disorders in vancomycin recipients remain unclear.