Dyselectrolytemias and acid-base disorder in acute kidney injury

Deshpandey, Ravi Prakash; Kumar, Hitesh; Mathew, Subin

doi:10.1016/s2211-9477(11)70009-7

Cited by 3 publications

(6 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The occurrence of hypocalcemia may be resulted from malnutrition, hypoalbuminemia, sepsis or tumor lysis syndrome (TLS) [27,28]. The release of phosphorus from damaged cells and cellular shift from intracellular to extracellular give rise to hyperphosphatemia, in situations including rhabdomyolysis, TLS, respiratory alkalosis and lactic and ketoacidosis [29]. Additionally, many of the fluids used for hydration and resuscitation contains high concentrations of chloride, and it also may induce or exacerbate hyperchloremia and MAC [30,31].…”

Section: Discussionmentioning

confidence: 99%

Electrolyte and acid-base disorders in cancer patients and its impact on clinical outcomes: evidence from a real-world study in China

et al. 2020

View full text Add to dashboard Cite

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 þ 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.

show abstract

Section: Discussionmentioning

confidence: 99%

Electrolyte and acid-base disorders in cancer patients and its impact on clinical outcomes: evidence from a real-world study in China

et al. 2020

View full text Add to dashboard Cite

show abstract

“…Therefore, there is evident loss of water, leading to hypovolemia, which causes AKI and concomitantly deteriorates the hypercalcemia. So, there is a continuous circle of hypercalcemia causing hypovolemia-induced AKI and vice versa (49)(50)(51). Moreover, hypercalcemia and hypercalciuria can lead to deposition of calcium, thus causing nephrolithiasis and renal calcification, which can cause the development of AKI (49)(50)(51).…”

Section: Vitamin D Toxicity Induced Akimentioning

confidence: 99%

“…So, there is a continuous circle of hypercalcemia causing hypovolemia-induced AKI and vice versa (49)(50)(51). Moreover, hypercalcemia and hypercalciuria can lead to deposition of calcium, thus causing nephrolithiasis and renal calcification, which can cause the development of AKI (49)(50)(51). Also, hypercalcemia can cause renal vasoconstriction, which subsequently leads to severe GFR decrease and AKI (49)(50)(51).…”

Section: Vitamin D Toxicity Induced Akimentioning

confidence: 99%

“…Moreover, hypercalcemia and hypercalciuria can lead to deposition of calcium, thus causing nephrolithiasis and renal calcification, which can cause the development of AKI (49)(50)(51). Also, hypercalcemia can cause renal vasoconstriction, which subsequently leads to severe GFR decrease and AKI (49)(50)(51). As for the hyperphosphatemia, it can cause acute phosphate nephropathy due to the tubulointerstitial deposition of phosphate calcium, a condition that concomitantly worsens the already-existing hyperphosphatemia, thus leading to a vicious circle of deterioration (49)(50)(51).…”

Section: Vitamin D Toxicity Induced Akimentioning

confidence: 99%

“…Also, hypercalcemia can cause renal vasoconstriction, which subsequently leads to severe GFR decrease and AKI (49)(50)(51). As for the hyperphosphatemia, it can cause acute phosphate nephropathy due to the tubulointerstitial deposition of phosphate calcium, a condition that concomitantly worsens the already-existing hyperphosphatemia, thus leading to a vicious circle of deterioration (49)(50)(51). As for the acute phosphate nephropathy, it can also be due to significant phosphate intake and the subsequent diarrhea-induced hypovolemia (52).…”

Section: Vitamin D Toxicity Induced Akimentioning

confidence: 99%

See 2 more Smart Citations

Vitamin D and Acute Kidney Injury: A Two-Way Causality Relation and a Predictive, Prognostic, and Therapeutic Role of Vitamin D

2021

View full text Add to dashboard Cite

Background: Acute kidney injury (AKI) constitutes a multi-factorially caused condition, which significantly affects kidney function and can lead to elevated risk of morbidity and mortality. Given the rising scientific evidence regarding vitamin D's (VitD's) multisystemic role, the connection between AKI and VitD is currently being studied, and the complex relation between them has started to be unraveled.Methods: A systematic review had been conducted to identify the pathogenetic relation of VitD and AKI and the potential role of VitD as a biomarker and therapeutic–renoprotective factor.Results: From 792 articles, 74 articles were identified that fulfilled the inclusion criteria. Based on these articles, it has been found that not only can VitD disorders (VitD deficiency or toxicity) cause AKI but, also, AKI can lead to great disruption in the metabolism of VitD. Moreover, it has been found that VitD serves as a novel biomarker for prediction of the risk of developing AKI and for the prognosis of AKI's severity. Finally, animal models showed that VitD can both ameliorate AKI and prevent its onset, suggesting its renoprotective effect.Conclusion: There is a complex two-way pathogenetic relation between VitD disorders and AKI, while, concomitantly, VitD serves as a potential novel predictive–prognostic biomarker and a treatment agent in AKI therapy.

show abstract

Comparison of Prediction Models for Acute Kidney Injury Among Patients with Hepatobiliary Malignancies Based on XGBoost and LASSO-Logistic Algorithms

Zhang¹,

Wang²,

Xu³

et al. 2021

IJGM

View full text Add to dashboard Cite

Background Based on the admission data, we applied the XGBoost algorithm to create a prediction model to estimate the AKI risk in patients with hepatobiliary malignancies and then compare its prediction capacity with the logistic model. Methods We reviewed clinical data of 7968 and 589 liver/gallbladder cancer patients admitted to Zhongshan Hospital during 2014 and 2015. They were randomly divided into the training set and test set. Data were collected from the electronic medical record system. XGBoost and LASSO-logistic were used to develop prediction models, respectively. The performance measures included the classification matrix, the area under the receiver operating characteristic curve (AUC), lift chart and learning curve. Results Of 6846 participants in the training set, 792 (11.6%) cases developed AKI. In XGBoost model, the top 3 most important variables for AKI were serum creatinine (SCr), glomerular filtration rate (eGFR) and antitumor treatment in liver cancer patients. Similarly, SCr and eGFR also ranked second and third most important variables in the gallbladder cancer-related AKI model just after phosphorus. In the classification matrix, XGBoost model possessed a comparably better agreement between the actual observations and the predictions than LASSO-logistic model. The Youden’s index of XGBoost model was 47.5% and 59.3%, respectively, which was significantly higher than that of LASSO-logistic model (41.6% and 32.7%). The AUCs of XGBoost model were 0.822 in liver cancer and 0.850 in gallbladder cancer. By comparison, the AUC values of Logistic models were significantly lower as 0.793 and 0.740 (p=0.024 and 0.018). With the accumulation of training samples, XGBoost model maintained greater robustness in the learning curve. Conclusion XGBoost model based on admission data has higher accuracy and stronger robustness in predicting AKI. It will benefit AKI risk classification management in clinical practice and take an advanced intervention among patients with hepatobiliary malignancies.

show abstract

Dyselectrolytemias and acid-base disorder in acute kidney injury

Cited by 3 publications

References 22 publications

Electrolyte and acid-base disorders in cancer patients and its impact on clinical outcomes: evidence from a real-world study in China

Electrolyte and acid-base disorders in cancer patients and its impact on clinical outcomes: evidence from a real-world study in China

Vitamin D and Acute Kidney Injury: A Two-Way Causality Relation and a Predictive, Prognostic, and Therapeutic Role of Vitamin D

Comparison of Prediction Models for Acute Kidney Injury Among Patients with Hepatobiliary Malignancies Based on XGBoost and LASSO-Logistic Algorithms

Contact Info

Product

Resources

About