Electrolyte abnormalities and laboratory findings in patients with out-of-hospital cardiac arrest who have kidney disease - 07/03/13
, Yi-Fang Tu, MD, PhD a, Wen-Chu Chiang, MD, MPH b, c, Shyu-Yu Wu, MS d, Ying-Hsin Chang, MD a, Chih-Hsien Chi, MD aAbstract |
Purposes |
Although electrolyte abnormalities have been generally considered the major cause of out-of-hospital cardiac arrest (OHCA) in patients with kidney disease (KD), this association has never been prospectively validated.
Methods |
A prospective, observational study was conducted in a tertiary university hospital between January 2008 and December 2009. The study sample consisted of consecutively admitted patients with nontraumatic OHCA. Based on the estimated glomerular filtration rate (eGFR, unit: milliliters per minute per 1.73 m2), the enrollees were divided into 3 groups: group A (normal kidney function or mild KD; eGFR, 60.0), group B (moderate KD; eGFR between 15.0 and 59.9), and group C (severe KD; eGFR<15.0 or on dialysis). The laboratory findings of the groups were compared. Two-tailed P values less than .005 were considered significant.
Results |
Two hundred thirty-four enrollees (137 were male) were divided into 3 groups: group A (n = 51; 21.8%), group B (n = 128; 54.7%), and group C (n = 55; 23.5%). Compared with the other 2 groups, group C presented significantly higher serum potassium and magnesium and lower pH and hemoglobin level (all P < .005). After stratifications of the significant variables, a post hoc analysis revealed that group C presented significantly higher incidences of hypermagnesemia (Mg >2.5 mmol/L) and severe hyperkalemia (K >6.5 mmol/L) (both P < .005) than the other 2 groups. The odds ratios of the incidence of severe hyperkalemia in group C was 3.37 (95% confidence intervals, 1.46-7.77) compared with group A (50.9% vs 23.5%, P < .005).
Conclusions |
Severe hyperkalemia is common in patients with OHCA who have severe KD and should be considered during resuscitation for these patients.
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| ☆ | Disclosures of conflict of interest: The authors disclose no conflicts. |
| ☆☆ | Ethical adherence: The study procedures were in accordance with the ethical standards and were approved by the institutional review board in the hospital. |
| ★ | Author contributions: C.H. Lin conceived and supervised the study. All authors were involved in acquisition of data. C.H. Lin, W.C. Chiang, and S.Y. Wu interpreted the data and performed statistical analysis. C.H. Lin drafted the manuscript, and all authors contributed substantially to its revision. C.H. Lin, Y.H. Chang, Y.F. Tu, and C.H. Chi offered administrative and technical supports. C.H. Lin is the corresponding author who takes responsibility for the manuscript as a whole. |
| ★★ | Funding and support: No financial support was granted. |
Vol 31 - N° 3
P. 487-493 - mars 2013 Retour au numéro
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