Acid-base and electrolyte abnormalities in patients with acute leukemia
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Milionis, H. J.
Bourantas, C. L.
Siamopoulos, K. C.
Elisaf, M. S.
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peer-reviewed
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Am J Hematol
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Disturbances of acid-base balance and electrolyte abnormalities are commonly seen in patients with acute leukemia. Our study aimed at illuminating the probable pathogenetic mechanisms responsible for these disturbances in patients with acute leukemia admitted to our hospital. We studied 66 patients (24 men and 44 women) aged between 17 and 87 years old on their admission and prior to any therapeutic intervention. Patients with diabetes mellitus, acute or chronic renal failure, hepatic failure, patients receiving drugs that influence acid-base status and electrolyte parameters during the last month, such as corticosteroids, cisplatin, diuretics, antacids, aminoglycosides, amphotericin, penicillin, and K(+), PO(4)(3-), or Mg(2+) supplements were excluded. Forty-one patients had at least one acid-base or electrolyte disturbance. There were no significant differences in the incidence of acid-base balance and electrolyte abnormalities between patients with acute myeloid leukemia (AML) and patients with acute lymphoblastic leukemia (ALL). The most frequent electrolyte abnormality was hypokalemia, observed in 41 patients (63%), namely in 34 patients with AML, and 7 with ALL; the main underlying pathophysiologic mechanism was inappropriate kaliuresis. Furthermore, hypokalemic patients more frequently experienced concurrent electrolyte disturbances (i.e., hyponatremia, hypocalcemia, hypophosphatemia, and hypomagnesemia), as well as various acid-base abnormalities compared to normokalemic patients. Hypokalemia in patients with acute leukemia may serve as an indicator of multiple concurrent, interrelated electrolyte disturbances, especially in patients with AML.
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Keywords
Acid-Base Imbalance/*etiology, Acidosis/etiology, Adolescent, Adult, Aged, Aged, 80 and over, Alkalosis/etiology, Anoxia/etiology, Electrolytes/*blood, Female, Humans, Hydrogen-Ion Concentration, Hypocalcemia/etiology, Hypokalemia/etiology, Hyponatremia/etiology, Hypophosphatemia/etiology, Leukemia, Myeloid, Acute/*complications, Magnesium Deficiency/etiology, Male, Middle Aged, Precursor Cell Lymphoblastic Leukemia-Lymphoma/*complications
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http://www.ncbi.nlm.nih.gov/pubmed/10589074
http://onlinelibrary.wiley.com/store/10.1002/(SICI)1096-8652(199912)62:4<201::AID-AJH1>3.0.CO;2-1/asset/1_ftp.pdf?v=1&t=h0m7ov10&s=88be6c9a780032437a79bf6559171441b896b046
http://onlinelibrary.wiley.com/store/10.1002/(SICI)1096-8652(199912)62:4<201::AID-AJH1>3.0.CO;2-1/asset/1_ftp.pdf?v=1&t=h0m7ov10&s=88be6c9a780032437a79bf6559171441b896b046
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en
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Πανεπιστήμιο Ιωαννίνων. Σχολή Επιστημών Υγείας. Τμήμα Ιατρικής