Hyponatremia in the cancer patient

Workeneh, Biruh; Jhaveri, Kenar D.; Rondon‐Berrios, Helbert

doi:10.1016/j.kint.2020.05.015

Cited by 35 publications

(27 citation statements)

References 141 publications

(159 reference statements)

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“…Over the recent years, a connection has been found between hyponatremia and a number of diseases: heart failure (Bettari et al,2012;Shchekochikhin et al, 2013;Ali et al, 2016), cirrhosis (Ginés et al, 1998;Gerbes et al, 2003;Ginès & Guevara, 2008), kidney failure (Pérez-García et al, 2016;Zhang et al, 2017), cancer (Berghmans et al, 2000;Castillo et al, 2016;Workeneh et al, 2020), alcoholism (Limias et al, 2000Stasiukynienė, 2002), and also age (Wannamethee et al, 2016). Hyponatremia was observed in patients during the post-surgery period (Leung, 2012;Leise & Findlay, 2017).…”

Section: Discussionmentioning

confidence: 99%

Level of natremia as an index of the condition of the organism of animals under stress

Zaprudnova

2021

Regul. Mech. Biosyst.

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In the diagnosis of stressful conditions in humans and other animals, ionic indicators remain practically unused. In this work, we studied the changes in the concentrations of sodium ions in the blood plasma of freshwater fish under stress caused by stressors of different quality and quantity. Most of the experiments were carried out on adult bream (Abramis brama L) from the Rybinsk Reservoir. Separate experiments were duplicated on adult individuals of roach (Rutilus rutilus L.), pike (Esox lucius L.), and blue bream (Abramis ballerus L.). The concentration of cations in the blood plasma was determined using a Flapho-4 flame photometer. Under the action of mild and short-term stressors of different qualities, the sodium concentration in the internal environment altered toward an increase in concentration gradients on the cell membrane (eustress or physiological stress). Hypernatremia was approximately 10%. Under the action of strong and/or prolonged stressors of different strength, the sodium concentration in the internal environment changed toward a decrease in concentration gradients on the cell membrane (distress or pathological stress). Hyponatremia was 50% in the conditions of acute lethal stress, 20% in subacute lethal stress, 10% or more in chronic lethal stress. During strong acute reversible stress, hyponatremia could reach 30%. Analysis of the material on mammals allowed us to conclude that the adaptation mechanisms in fish and higher vertebrates are similar. In this work, for the first time, the state of the system of electrolyte balance of animals under stress was analyzed from the standpoint of the leading role of ionic concentration gradients on the cell membrane (mainly sodium) in the energetics (level of disequilibrium) of the organism. We propose a concept that in normal and extreme conditions fish use two different defense reactions (or adaptation strategies): active and passive, consisting, respectively, in increasing or decreasing the level of disequilibrium (energy) in the organism. The hyponatremia recorded by numerous authors, which accompanies diseases in humans, is evidently a nonspecific reaction of the organism and serves as an indicator of reduced energy of the organism. It is suggested that the sodium level in the internal environment of the organism be used for diagnosing the stress state of animals.

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Section: Discussionmentioning

confidence: 99%

Level of natremia as an index of the condition of the organism of animals under stress

Zaprudnova

2021

Regul. Mech. Biosyst.

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“…MG is located intracellularly in 99% percent of the total body, which includes bones, skeletal muscles, and non-muscular soft tissues, leaving only 1% in the extracellular space (serum and red blood cells). 21 The kidneys easily filter 70% of the total body MG, either as complex anions (oxalate, phosphate, citrate) or ionised MG. 21,23 The remaining 30% of the total body plasma MG is bound to proteins, mainly albumin. 21,23 MG's homeostasis is mainly regulated by the intestines, kidneys, and bones.…”

Section: Physiology Of Magnesium Homeostasismentioning

confidence: 99%

“…21 The kidneys easily filter 70% of the total body MG, either as complex anions (oxalate, phosphate, citrate) or ionised MG. 21,23 The remaining 30% of the total body plasma MG is bound to proteins, mainly albumin. 21,23 MG's homeostasis is mainly regulated by the intestines, kidneys, and bones. MG is absorbed in the gut and stored in bones, and the excess is excreted by the kidneys and intestines.…”

Section: Physiology Of Magnesium Homeostasismentioning

confidence: 99%

Epidermal Growth Factor Receptor Inhibitor-Induced Hypomagnesaemia: Is There a Best Replacement Strategy?

Siddiqui

Ahmed

Vickers

2021

EMJ

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Monoclonal antibodies targeting the epidermal growth factor receptor (EGFRI), such as cetuximab and panitumumab, are commonly used systemic therapies for advanced colorectal and head and neck cancers. Hypomagnesaemia is a common side effect of these therapies and occurs in up to 30% of patients. Interruption of EGFR signalling in the distal convoluted tubule leads to inactivation of the transcellular transporter transient receptor potential channel melastatin member 6 and increased renal magnesium excretion. This paper describes the incidence, risk factors, and the emerging management options for EGFRI-induced hypomagnesaemia.

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“…In clinical practice, two situations where hyponatremia is not accompanied by hypo-osmolality, i.e., pseudohyponatremia and translocational hyponatremia, should be considered in the differential diagnosis of true hyponatremia. Pseudohyponatremia, as a type of isotonic hyponatremia, is derived from a laboratory artifact: excess plasma protein or lipid reduces the water content of a given volume of plasma, thereby reducing the [Na + ] concentration per unit of plasma; in fact, the [Na + ] concentration in the water phase is normal (e.g., in hyperproteinemia or hypertriglyceridemia) [2][3][4]. Translocational hyponatremia, as a type of hypertonic or isotonic hyponatremia, occurs with the presence of large amounts of osmotically-active solutes, which can lead to fluid shift from intracellular to extracellular space, thus yielding dilutional hyponatremia (e.g., in hyperglycemia) [2][3][4].…”

Section: Introductionmentioning

confidence: 99%

“…Pseudohyponatremia, as a type of isotonic hyponatremia, is derived from a laboratory artifact: excess plasma protein or lipid reduces the water content of a given volume of plasma, thereby reducing the [Na + ] concentration per unit of plasma; in fact, the [Na + ] concentration in the water phase is normal (e.g., in hyperproteinemia or hypertriglyceridemia) [2][3][4]. Translocational hyponatremia, as a type of hypertonic or isotonic hyponatremia, occurs with the presence of large amounts of osmotically-active solutes, which can lead to fluid shift from intracellular to extracellular space, thus yielding dilutional hyponatremia (e.g., in hyperglycemia) [2][3][4]. Depending on the ECF volume status, the hypotonic hyponatremia can be divided into three categories: hypovolemic (decreased total body water [TBW] and ECF volume with a greater decrease in total body sodium, caused by gastrointestinal fluid losses, diuretic therapy, etc.…”

Section: Introductionmentioning

confidence: 99%

Preoperative hyponatremia predicts complications in older patients undergoing digestive tract surgery: a propensity score matching analysis

Zhang

Fan

et al. 2021

Eur Geriatr Med

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Purpose Whether preoperative hyponatremia increases the risk of postoperative complications in older patients undergoing digestive tract surgery remains unclear. The purpose of the study was to investigate the association between preoperative hyponatremia and life-threatening postoperative complications (including death) among older patients undergoing digestive tract surgery. Methods This was a propensity score-matched, retrospective cohort study. We recruited older patients (≥ 65 years of age) who underwent digestive tract surgery in our institution. The propensity score matching (PSM; 1:2) was used to balance a range of covariates between patients with preoperative hyponatremia (serum sodium [Na+] levels < 135 mmol/L) and those with normal [Na+] levels (135–145 mmol/L). The primary outcome was the occurrence of life-threatening postoperative complications and mortality (i.e., Clavien–Dindo grade IV and V [CD IV and V] complications) during hospital stay. The relationship between preoperative hyponatremia and the development of CD IV and V complications was identified with logistic regression analysis. Results A total of 1076 patients were analyzed (mean age 73.9 years; 421 female [39.1%]). Preoperative hyponatremia was identified in 122 patients. After matching, 312 patients were included in the analyses (104 patients with preoperative hyponatremia and 208 patients with normal [Na+] levels; mean age, 76.3 years; 130 female [41.7%]). When compared with normal [Na+] levels, preoperative hyponatremia was associated with an increased risk of CD IV and V complications (odds ratio [OR] 2.082, 95% confidential interval [CI] 1.041–4.164, P = 0.038). Preoperative hyponatremia was also significantly associated with a higher risk of postoperative infectious complications (OR 2.158, 95% CI 1.138–4.091, P = 0.018). Conclusion Preoperative hyponatremia can predict an increased risk of life-threatening postoperative complications and mortality in older patients undergoing digestive tract surgery.

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Hyponatremia in the cancer patient

Cited by 35 publications

References 141 publications

Level of natremia as an index of the condition of the organism of animals under stress

Level of natremia as an index of the condition of the organism of animals under stress

Epidermal Growth Factor Receptor Inhibitor-Induced Hypomagnesaemia: Is There a Best Replacement Strategy?

Preoperative hyponatremia predicts complications in older patients undergoing digestive tract surgery: a propensity score matching analysis

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