Yang Li1,2,3,4,5, Xiaohong Chen1,2,3,4,5, Ziyan Shen1,2,3,4,5, Yimei Wang1,2,3,4,5, Jiachang Hu1,2,3,4,5, Jiarui Xu1,2,3,4,5, Bo Shen1,2,3,4,5, Xiaoqiang Ding1,2,3,4,5. 1. Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China. 2. Shanghai Medical Center of Kidney, Shanghai, China. 3. Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai, China. 4. Shanghai Institute of Kidney and Dialysis, Shanghai, China. 5. Hemodialysis Quality Control Center of Shanghai, Shanghai, China.
Abstract
Background: This study aims to delineate the incidence of electrolyte and acid-base disorders (EAD) in cancer patients, to figure out the risk factors of EAD, then to assess the impact of EAD on patients' in-hospital clinical outcomes. Methods: Patients with the diagnosis of malignancies hospitalized during 1 October 2014 and 30 September 2015 were recruited in Zhongshan Hospital, Fudan University in Shanghai of China. Demographic characteristics, comorbidities, and clinical data, including survival, length of stay and hospital cost, were extracted from the electronic medical record system. Electrolyte and acid-base data were acquired from the hospital laboratory database. Results: Of 25,881 cancer patients with electrolyte data, 15,000 (58.0%) cases had at least one electrolyte and acid-base abnormity. Hypocalcemia (27.8%) was the most common electrolyte disorder, followed by hypophosphatemia (26.7%), hypochloremia (24.5%) and hyponatremia (22.5%). The incidence of simple metabolic acidosis (MAC) and metabolic alkalosis (MAL) was 12.8% and 22.1% respectively. Patients with mixed metabolic acid-base disorders (MAC + MAL) accounted for 30.2%. Lower BMI score, preexisting hypertension and diabetes, renal dysfunction, receiving surgery/chemotherapy, anemia and hypoalbuminemia were screened out as the major risk factors of EAD. In-hospital mortality in patients with EAD was 2.1% as compared to those with normal electrolytes (0.3%). The risk of death significantly increased among patients with severe EAD. Similarly, the length of stay and hospital cost also tripled as the number and grade of EAD increased. Conclusion: EAD is commonly encountered in cancer patients and associated with an ominous prognosis. Patients with comorbidities, renal/liver dysfunction, and anti-tumor therapy have a higher risk of EAD. Regular monitoring of electrolytes, optimum regimen for intravenous infusion, timely correction of modifiable factors and appropriate management of EAD should not be neglected during anti-tumor treatment.
Background: This study aims to delineate the incidence of electrolyte and acid-base disorders (EAD) in cancerpatients, to figure out the risk factors of EAD, then to assess the impact of EAD on patients' in-hospital clinical outcomes. Methods:Patients with the diagnosis of malignancies hospitalized during 1 October 2014 and 30 September 2015 were recruited in Zhongshan Hospital, Fudan University in Shanghai of China. Demographic characteristics, comorbidities, and clinical data, including survival, length of stay and hospital cost, were extracted from the electronic medical record system. Electrolyte and acid-base data were acquired from the hospital laboratory database. Results: Of 25,881 cancerpatients with electrolyte data, 15,000 (58.0%) cases had at least one electrolyte and acid-base abnormity. Hypocalcemia (27.8%) was the most common electrolyte disorder, followed by hypophosphatemia (26.7%), hypochloremia (24.5%) and hyponatremia (22.5%). The incidence of simple metabolic acidosis (MAC) and metabolic alkalosis (MAL) was 12.8% and 22.1% respectively. Patients with mixed metabolic acid-base disorders (MAC + MAL) accounted for 30.2%. Lower BMI score, preexisting hypertension and diabetes, renal dysfunction, receiving surgery/chemotherapy, anemia and hypoalbuminemia were screened out as the major risk factors of EAD. In-hospital mortality in patients with EAD was 2.1% as compared to those with normal electrolytes (0.3%). The risk of death significantly increased among patients with severe EAD. Similarly, the length of stay and hospital cost also tripled as the number and grade of EAD increased. Conclusion:EAD is commonly encountered in cancerpatients and associated with an ominous prognosis. Patients with comorbidities, renal/liver dysfunction, and anti-tumor therapy have a higher risk of EAD. Regular monitoring of electrolytes, optimum regimen for intravenous infusion, timely correction of modifiable factors and appropriate management of EAD should not be neglected during anti-tumor treatment.
Authors: Harish Seethapathy; Nifasha Rusibamayila; Donald F Chute; Meghan Lee; Ian Strohbehn; Leyre Zubiri; Alexander T Faje; Kerry L Reynolds; Kenar D Jhaveri; Meghan E Sise Journal: Nephrol Dial Transplant Date: 2021-12-02 Impact factor: 5.992
Authors: Timo Schmitz; Christian Thilo; Jakob Linseisen; Margit Heier; Annette Peters; Bernhard Kuch; Christa Meisinger Journal: Sci Rep Date: 2021-01-28 Impact factor: 4.379