STATE OF ELECTROLYTE BALANCE OF BLOOD IN PATIENTS WITH CHRONIC KIDNEY DISEASE VD STAGES TREATED WITH SOFTWARE HEMODIALYSIS
DOI:
https://doi.org/10.11603/1811-2471.2020.v.i3.11595Keywords:
chronic kidney disease, hemodialysis, electrolytes, secondary hyperparathyroiditisAbstract
The progression of chronic kidney disease (CKD) is characterized by impaired metabolism of blood electrolytes in two forms – hyperelectrolytemia or hypoelectrolytemia.
The aim – to assess the balance of biostructural and bioelectrolytic elements of blood P, Ca, K, Na, Mg, Cl in relation to the function of the parathyroid glands in patients with CKD VD stage, who are treated with program hemodialysis.
Material and Methods. 30 patients with CKD VD stage were examined. The state of electrolyte balance was assessed by K, Na, Ca, Mg, Cl and biostructural element P in relation to the level of intact parathyroid hormone.
Results. Among the examined patients revealed signs of secondary hyperparathyroiditis of varying severity, electrolyte imbalance K, Na, Ca, Mg, Cl and biostructural element P in the blood. Of particular clinical importance is the tendency to form hypercalcemia on the background of hypomagnesemia – predictors of cardiovascular events.
Conclusion. In more than 80 % of cases of patients with stage VD chronic kidney disease treated with programmed hemodialysis, the development of electrolyte imbalance K, Na, Ca, Mg, Cl and biostructural element P is typical. The severity of their imbalance is associated with the development of secondary hyperparathyroidism.
References
Skalnyi, A.V. (2019). Mikroelementy: bodrost, zdorovye, dolgoletiye [Trace elements: vigor, health, longevity]. Moscow: “Pero” [in Russian].
Lytvytskyi, P.F. (2015). Narusheniya yonnogo obmena [Ion exchange disorders]. Voprosy sovremennoy pediatrii – Issues of Current Pediatrics, 14 (3), 349-357 [in Russian].
Ting, I.W., Yeh, H.C., & Huang, H.C. (2020). Joint longitudinal low calcium high phosphorus trajectory associates with accelerated progression, acute coronary syndrome and mortality in chronic kidney disease. Sci. Rep., 10 (1), 96-82. DOI: https://doi.org/10.1038/s41598-020-66577-7
Michel, L.Y., Hoenderop, J.G., & Bindels, R.J. (2015). Towards understanding the role of the Na2+ - Ca2+ exchanger isoform. Physiol. Biochem. Pharmacol.,168, 31-57. Retrieved from: https://www.ncbi.nlm.nih.gov/pubmed/25851230.
Palmer, S., Teixeira-Pinto, A., & Saglimbene, V. (2015). Association of drug effects on serum parathyroid hormone, phosphorus, and calcium levels with mortality in CKD: A meta-analysis. Am. J. Kidney Dis., 66 (6), 962-971. DOI: https://doi.org/10.1053/j.ajkd.2015.03.036
Navarro, J.F., Mora, C., & Jimenez, A. (1999). Relationship between serum magnesium and parathyroid hormone levels in hemodialysis patients. Am. J. Kidney Dis., 34, 43-48. DOI: https://doi.org/10.1016/S0272-6386(99)70106-X
Hutchison, A.J., Were, A.J., & Boulton, H.F. (1996). Hypercalcaemia, hypermagnesaemia, hyperphosphataemia and hyperaluminaemia in CAPD: improvement in serum biochemistry by reduction in dialysate calcium and magnesium concentrations. Nephron., 72, 52-58. DOI: https://doi.org/10.1159/000188806
Orynchak, M.A., Haman, I.O., Artemenko, N.R., Chovhanyuk, O.S., Kocherzhat, O. I., & Kobrynska, O.Ya. (2017). Nespryiatlyvi chynnyky perebihu khronichnoi khvoroby nyrok: endokrynopatii [Adverse factors of chronic kidney disease: Endocrinopathy]. Art of Medicine, 3, 66-71 [in Ukrainian].
