Electrolyte abnormalities and laboratory findings in patients with out-of-hospital cardiac arrest who have kidney disease
Journal
American Journal of Emergency Medicine
Journal Volume
31
Journal Issue
3
Pages
487-493
Date Issued
2013
Author(s)
Abstract
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. ? 2013 Elsevier Inc. All rights reserved.
SDGs
Other Subjects
epidermal growth factor receptor; hemoglobin; magnesium; potassium; acidemia; adult; aged; article; confidence interval; controlled study; dialysis; disease severity; female; glomerulus filtration rate; hemoglobin blood level; hospital admission; human; hyperkalemia; hypermagnesemia; incidence; kidney disease; kidney function; laboratory test; magnesium blood level; major clinical study; male; observational study; out of hospital cardiac arrest; pH; post hoc analysis; potassium blood level; priority journal; prospective study; risk; tertiary health care; university hospital; Aged; Aged, 80 and over; Biological Markers; Female; Hemoglobins; Humans; Hyperkalemia; Incidence; Kidney Diseases; Magnesium; Male; Middle Aged; Odds Ratio; Out-of-Hospital Cardiac Arrest; Prospective Studies; Severity of Illness Index; Water-Electrolyte Imbalance
Type
journal article