Changes in Basic Blood Serum Electrolytes in Men Under 60 Years Old With Myocardial Infarction, Complicated by Acute Kidney Injury

Abstract

Abstract. Relevance. Acute kidney injury during myocardial infarction worsens the prognosis. At the same time, changes in electrolyte metabolism have been studied only in cases of severe lesions. And most of the data were obtained for patients over 60 years old. Aim. To evaluate the features of changes in serum potassium, sodium, calcium, and chlorides in men under 60 years old with myocardial infarction complicated by acute kidney injury to improve prevention and outcomes. Material and methods. The study included men 19-60 years old with type I myocardial infarction. The patients were divided into two age-comparable groups: I - study group, with acute kidney injury - 25 patients; II - control, without it - 168 patients. A comparative analysis of serum sodium, potassium, calcium and chloride concentration in the first 48 hours (1) and at the end of the third week of the disease (2), their dynamics, analysis of their impact on the risk of acute kidney injury (ANOVA) were performed. Results. The study group differed from the control in high levels of sodium (143.3 ± 3.4 and 140.3 ± 4.5 (mmol/l); respectively; p = 0.004) and chlorides (104.6 ± 2.7 and 102.8 ± 3.5 (mmol/l); p = 0.047) at the end of the third week of the disease. The concentrations of the studied electrolytes increased at the second observation point in both groups of patients. The main markers of the acute kidney injury risk development in the first hours of myocardial infarction were: potassium levels < 4.75 mmol/l (absolute risk: 17.2%; p = 0.003), sodium ≥ 140 mmol/l (absolute risk: 18.2%; relative - 3.64; p = 0.01), chlorides ≥ 104 mmol/l (absolute risk: 22.6%; relative - 3.67; p = 0.02). Conclusions. Men under 60 years old with acute kidney injury in myocardial infarction are characterized by low levels of potassium (<4.75 mmol/l) as well as higher levels of sodium (≥140 mmol/l) and chloride (≥104 mmol/l) serum in the first hours of IM. The listed above values should be used in the formation of the high-risk groups for the acute kidney injury development, as well as for prognostic modeling.