Disorders Of Electrolyte Balance Research Articles

Basic principles of infusion therapy

Infusion therapy (IT) is an essential tool for influencing homeostasis and an integral part of the complex treatment of urgent conditions and chronic diseases accompanied by fluid and electrolyte balance disorders. To this day the features of infusion therapy remain one of the most controversial and poorly studied topics, despite the centuries-old use of this method of treatment. Rational use of IT requires a clear understanding of the pathophysiological changes occurring in the patient’s body during acute and chronic pathology. Its main tasks are the elimination of volemic disorders, replenishment of circulating blood volume, restoration of microcirculation, as well as detoxification and elimination of hemocoagulation disorders. IT acquires particular importance as parenteral nutrition, with limited or excluded possibility of the enteral route of absorption of water, nutrients, and drugs. In the work, the authors focused on clinical and laboratory diagnostics and possible options for correcting acid-base, energy, fluid, and electrolyte disorders. The sequence of actions when prescribing IT is presented in detail; the criteria for calculating the volume of therapy and the initial selection of colloids or crystalloids for a specific clinical situation are considered.

Analysis of Factors That Play a Role in the Length of Treatment in Hyperemesis Gravidarum Patients at Raja Ahmad Tabib General Hospital Tanjungpinang, Indonesia

Hyperemesis gravidarum (HG) is a pregnancy complication characterized by excessive nausea and vomiting, which can cause dehydration, electrolyte balance disorders and weight loss. The length of stay for HG patients in hospital can vary. This study aims to analyze the factors that contribute to the length of treatment for HG patients at Raja Ahmad Tabib General Hospital Tanjungpinang, Indonesia. This research was conducted with an analytical observational design with a retrospective approach. Data was collected from medical records of HG patients treated at Raja Ahmad Tabib General Hospital Tanjungpinang in the period January 2020 to December 2022. This was done using multiple linear regression. The dependent variable is length of treatment (days). The independent variables analyzed were maternal age, parity, severity of HG, nutritional status, and accompanying complications. A total of 100 HG patients were included in this study. The average length of treatment is 3.5 days. The results of the analysis showed that the factors that contributed to the length of treatment for HG patients were maternal age (p=0.02), parity (p=0.04), and severity of HG (p=0.001). Maternal age, parity, and severity of HG are factors that contribute to the length of treatment for HG patients at Raja Ahmad Tabib General Hospital Tanjungpinang.

Perioperative acute kidney injury in surgical treatment of renal cancer: pathogenesis, therapy of early and late complications

The development of acute renal injury is due to a number of factors both on the part of the patient (age, concomitant pathology, objective status) and the oncological process (stage of the disease, localization, volume of surgical intervention, access, etc.). Acute renal injury in patients with kidney cancer after surgical treatment may be accompanied by the development of early (hyperhydration, electrolyte balance disorders, hyperkalemia, acid‑base condition disorders, uremic intoxication) and late chronic kidney disease complications. The incidence of these complications increases with an increase in the volume of kidney resection, as a result of which it is important to take into account risk factors, timely diagnosis of the degree of kidney damage and medical measures aimed at restoring kidney function. Currently, the possibility of using various molecules as early markers of kidney damage, which help not only assess the presence of kidney damage, but also localize it, is being studied. For example, albumin, serum cystatin C, alpha 1‑microglobulin, P2‑microglobulin – markers of glomerular damage, NGAL, KIM‑1; L‑FABP, urine cystatin‑C, IL‑18 – reflect damage to the proximal tubule, GST, NGAL – distal tubule, calibindin D28 ‑ characterizes damage to the collecting duct, osteopontin, NHE‑3 – are associated with damage to the loop of Henle. Measures of a curative and preventive nature (infusion therapy, anti‑ischemic protection, modulation of ferroptosis, renal replacement therapy), as well as dynamic monitoring of the main biomarkers of renal damage are aimed at preventing the persistence of the pathological process with a possible outcome into chronic kidney disease, which is especially undesirable in patients with single kidney cancer. The main directions of medical and preventive measures in patients with acute kidney injury should be considered: 1) the fastest possible elimination or minimization of the effect of tumor tissue; 2) control and correction of life‑threatening complications of renal dysfunction (hyperhydration, electrolyte balance disorders (hyperkalemia), acid‑base state, uremic intoxication). Methods of anti‑ischemic protection include a number of surgical techniques aimed at 1) minimizing ischemia time, 2) reducing the intensity of volatile metabolic processes in the kidney, 3) training renal parenchyma for hypoxic conditions (receiving ischemic preconditioning).Duration of renal ischemia represents an important modifiable factor affecting early and distant renal function in surgically exposed patients. The article analyzes modern scientific data on the problem of postoperative acute kidney injury in renal cancer surgery.

Regulatory mechanisms for maintaining homeostasis of sodium ions

According to general scientific recognition, the content of sodium ions in the body of a healthy person is quite constant, and among the multifaceted biological functions of this electrolyte, participation in maintaining water-salt homeostasis is the most important. Deviations from the normal level of concentration of sodium ions in the blood plasma are the most common electrolyte balance disorders in clinical medicine; however, dysionias still remain a relevant subject of research, in particular, their pathogenetic aspects and the possibilities of pharmacological correction. Sodium as an electrolyte is essential for the volume of extracellular fluid the content of which is inversely related to the urinary excretion of sodium ions. Sodium homeostasis is tightly regulated. In the reactions of ensuring the sodium balance in the body, the kidneys play a leading role, and the changes in their functional state are mediated through the action of the basic neurohumoral regulatory systems. The main renal homeostatic processes — glomerular filtration, tubular reabsorption and secretion — are of decisive importance for the removal of excess ions of sodium or its retention in the body. At the same time, it was found that there are also extrarenal mechanisms that are still being studied. Moreover, a number of studies have suggested that sodium ions can be stored in body tissues without adequate retention of water to buffer the electrolyte. Given the participation of the kidneys in maintaining normal functional and metabolic relationships and in pathological syndromes related to other organs, it is possible to predict the correlation of the activity of established and new markers of extrarenal mechanisms with reducers of water-electrolyte exchange the final effects of which are mediated through changes in the functional state of the kidneys. Evaluation of additional sodium-regulatory systems is a promising current direction for expanding ideas about mechanisms of stability of electrolytes and water.

Analysis of Risk Factor Hypoalbuminemia on the Incidence of Hyponatremia in Children with Nephrotic Syndrome

Background: Nephrotic syndrome is a clinical condition characterized by massive proteinuria, hypoalbuminemia, edema and may be accompanied by hypercholesterolemia. Proteinuria in childhood nephrotic syndrome is mainly in the form of albuminuria. In nephrotic syndrome, electrolyte balance disorders can occur in the form of hyponatremia which can cause complications from asymptomatic clinical manifestations to death. Currently, there are not many studies on hyponatremia in nephrotic syndrome. Objective: To determined hypoalbumin as a risk factor for hyponatremia in children with nephrotic syndrome. Methods: This research was an analytic observational study using a case control design. The subjects consisted of 80 children diagnosed with nephrotic syndrome at the Children's Health Installation at the Dr. Sardjito in Yogyakarta. The data collected included serum albumin levels and sodium levels. Statistical test using Odds Ratio (OR). .Results: The results showed that hypoalbumin (p = 0.000 ; OR 13,5; 95% CI 3,395 – 53,68) was a risk factor for the incidence of hyponatremia in children with nephrotic syndrome at the Children's Health Unit, Dr. Sardjito General Hospital in Yogyakarta. Conclusion: Hypoalbumin is a risk factor for hyponatremia in children with nephrotic syndrome

Investıgatıon of Lipid Profile, Malondialdehyde, Sodium, Potassium, Chloride Levels in Rats with Weight Loss

The aim of the fight against obesity is weight loss. Sometimes, the damage caused by weight loss can be ignored rather than its benefits. This situation; Sometimes, shock diet or excessive exercise can lead to unwanted consequences that can lead to sudden death. The purpose of our study; to examine changes in lipid profile, malondialdehyde levels in rats we have created weight loss. Also, it is to investigate changes in sodium and potassium chloride levels, which are of great importance inside and outside the cell. Twenty rats were used in the study. We randomly divided them into two groups. We exercised rats for 10 days. Triglyceride, cholesterol, (high-density-lipoprotein)HDL-cholesterol, (low-density-lipoprotein)LDL-cholesterol, Malondialdehyde, sodium, potassium chloride levels were analyzed. Sodium(p=0.034), potassium(p=0.018) and LDL-cholesterol(p=0.004) levels of the group with high weight loss were lower than the other group, Malondialdehyde(p=0.005) levels were found to be higher. Weight loss correlates negatively with sodium(p=0.031), potassium(p=0.005), chloride(p=0.036), LDL-cholesterol(p<0.001), HDL-cholesterol(p=0.035) and cholesterol(p=0.001). Weight loss correlates positively with Malondialdehyde(p=0.001). Weight loss causes the desired decrease in lipid profile and an unwanted increase in Malondialdehyde levels. Also, weight loss correlates negatively with sodium, potassium, and chloride levels. Both oxidative stress and electrolyte balance disorders can be life-threatening.

Central Pontine Myelinolysis in a Child: Clinical Case

Background. Central pontine myelinolysis (CPM) is limited symmetric non-inflammatory demyelination in the middle part of pontine. This disease is based on electrolyte balance disorders. Although CPM was firstly described in adults, but it can also occur in children. Every new case of CPM in children has undeniable interest and high scientific and practical significance due to its low incidence. Clinical case description. The child, 7 years old, had acute development, lethargy, multiple vomiting, subfebrile fever, pains in epigastric region. It has happened after drinking an unknown herb growing in the yard and previously covered with the insecticide "Akarin", according to the mother. The child was hospitalized in the pediatric department at the place of residence. The patient developed strabismus, swallowing disorder, and muscle weakness on infusion therapy. Biochemical blood test has shown hypokalemia and hyponatremia. Head MRI has shown symmetrical focal lesion of heterogeneous structure in pontine. Conclusion. Distinctive feature of this case is the development of CPM in a child on the ongoing therapy of hypokalemia and hyponatremia. The timely provision of qualified medical care has favoured the child's recovery.

Identifikasi Tipe Dehidrasi dan Profil Elektrolit Mayor pada Pasien Kucing di Rumah Sakit Hewan Prof. Soeparwi dan Beberapa Klinik Hewan di Wilayah Yogyakarta

Dehydration is defined as a lack of body fluids followed by loss of electrolytes, and changes in acid-base balance. The type of dehydration is limited based on the concentration of sodium in serum at the time of dehydration. Maintenance of osmotic pressure and distribution of several compartments of body fluids are the main functions of the four major electrolytes, namely sodium (Na +), potassium (K +), chloride (Cl‾), and bicarbonate (HCO3‾). Sodium is the most cation in extracellular fluid, most potassium cation in intracellular fluid and chloride is the most anion in extracellular fluid. The purpose of this study was to identify the type of dehydration and to determine the major electrolyte profile in cats in Yogyakarta and its surroundings. This study used 18 sick cats that were thought to be dehydrated, marked by decreased skin turgor, CRT&gt; 2 seconds, and 12 cats that were suspected of having electrolyte balance disorders with symptoms of ascites, uropoetic disorders. Blood was drawn for all cats to measure Pack Cells Volume (PCV) levels. Patient clinical data and patient diagnosis were recorded, cats with changes in serum PCV levels were separated for examination of levels of sodium, chloride, potassium using Seamaty SMT-120V. The type of dehydration is identified based on the sodium level in the serum of a dehydrated cat. The results showed that most of the cat patients were dehydrated had low serum sodium levels (hyponatremia). There was 1 cat patient had low chloride levels. Potassium levels in cats with UT obstruction increased, which led to a decrease in the Na: K ratio. Cat bicarbonate levels did not show any change. From the results of the study it was concluded that dehydration in cats at Prof. Soeparwi is hypotonic dehydration (71%). The sodium profile mostly decreased, chloride and bicarbonate levels did not change, while there were changes in potassium levels in patients with UT disorders. The advice given is to check electrolytes before doing fluid therapy. Prior to electrolyte testing, dehydrated cats can be given a sodium solution.

NON-STANDARD APPROACHES TO UPPER URINARY TRACT RECONSTRUCTION

The main alternatives to a standard ureteral reconstruction at the expense of urothelial−containing tissues are an autotransplantation of the kidney, replacement of the ureter, and interposition of autologous tissues that do not contain urothelium. This compares the tissues that have a similar histological structure, system of blood supply and innervation. Although the general trend in the assessment of the role of renal autological transplantation in the correction of ureteral defects is quite optimistic, there is a likelihood of severe complications, including severe transplant infection and its loss, complications from vascular anastomoses. At the same time the tissues having similar histological structure, system of blood supply and innervation have been compared. However, in some clinical situations it is not possible to replace the upper urinary tract with such a surgical approach, which forces the surgeon to use alternative and non−standard methods of ureteral reconstruction. Among the various types of ureteral reconstruction with enteral tissues, the leading role is the interposition of segments of the small intestine. Most authors point to the favorable results of this technique in terms of minimal lethality, low incidence of complications and stabilization of renal function after surgery. However, the problem of intestinal interposition is complications associated with enterotomy, electrolyte balance disorders, reabsorption into the blood of metabolism products and active secretion of mucus into the lumen of the urinary tract. The published reports have mostly described the positive results after ureteral plasticity of the buccal mucosa flap, but the length of the stricture in the implementation of such a treatment method should not exceed 5−6 cm ureter. Key words: ureteral reconstruction, kidney autotransplantation, intestinal ureteroplasty, ureteral reconstruction with buccal mucosa flap.

Toxicosis (vomiting) of pregnant women - diagnostic difficulties, critical complications

Vomiting (toxicosis) of pregnant women is a complex clinical syndrome, manifested in the first half of pregnancy. For this pathology, dyspeptic disorders characterized by significant consequences for the body: dehydration, fat, protein, carbohydrate metabolism and electrolyte balance disorders are characteristic. If at an early stage an underestimation of the condition of a pregnant woman occurs, then as the severity increases, dystrophic changes in the liver, kidneys, brain and other organs threatening the development of life-critical conditions may occur. It should be specially noted that even abortion in such a situation may not lead to an improvement in the state, since it is already impossible to analyze the degree of disturbance of the homeostasis system of vital organs structures by separate diagnostic criteria. This article presents an analysis of a very rare clinical case - the development in a patient with vomiting of pregnant patients with severe neurological pathology - Guillain-Barre syndrome with a fatal outcome. The analysis of the patient's management was conducted, conclusions were drawn about the belated untimely termination of pregnancy, the absence of pyridoxine in the complex treatment, which could contribute to the lethal outcome of the disease. It is noted that doctors do not adequately assess the severity of the disease, do not conduct a full examination and treatment, late decide on the termination of pregnancy.

Gene expression of 11beta-hydroxysteroid dehydrogenase type 1 and type 2 in the kidneys of insulin-dependent diabetic rats.

The presence of 11beta-hydroxysteroid dehydrogenase (11beta-HSD) activity in the kidney has been suggested to be important in the regulation of glucocorticoid-induced disorders of electrolyte balance and the control of blood pressure. To assess the possible effect of 11beta-HSD isoforms in diabetes-related hypertension, we measured the mean systolic blood pressure and the 11beta-HSD activity and mRNA levels for both 11beta-HSD1 and 11beta-HSD2 in the kidney of streptozotocin (STZ)-diabetic female rats. Three weeks after injection of STZ (65 mg/kg), the mean systolic blood pressure of diabetic rats was elevated 13.6% above that of normal rats (P<.01). The renal 11beta-HSD2 activity and level of mRNA expression were significantly decreased in diabetic rats (P<.01). However, the treatment of rats with STZ did not decrease the levels of renal 11beta-HSD1 activity and mRNA expression in diabetic rats. Insulin administered subcutaneously to diabetic rats for 2 weeks completely reversed the decrease in renal 11beta-HSD2 activity and gene expression and prevented the elevation in blood pressure in the diabetic rat. These results indicate that alteration of renal 11beta-HSD2 activity and gene expression may be primarily responsible for the changes in blood pressure of STZ-diabetic rats after early treatment with insulin.

Fluid Therapy and Disorders of Electrolyte Balance.

Fluid Therapy and Disorders of Electrolyte Balance.

The effects of disorders of electrolyte balance on the structure and function of the kidneys

Die verschiedenen Ursachen der klinisch relevanten primaren Storungen des Mineralhaushaltes (Hypokaliamie, Hyponatriamie, Hypernatriamie, Hypercalcamie) sind tabellarisch aufgefuhrt. Fur jede der angefuhrten Elektrolytstorungen werden zunachst die resultierenden morphologischen und histologischen Veranderungen der Nieren angegeben, wie sie nach experimenteller Beeinflussung des Elektrolytstoffwechsels im Tierversuch sowie bei entsprechenden klinischen Beobachtungen bioptisch oder autoptisch am Menschen gefunden wurden. Soweit bekannt, werden elektronenoptische und histochemische Befunde aufgefuhrt. Die Auswirkung primarer Elektrolytstorungen auf die Nierenfunktion wird fur jede der aufgefuhrten Syndrome hinsichtlich der Beeintrachtigung der Harnkonzentrationsfahigkeit, der Natrium- und Kaliumausscheidung sowie der renalen Regulation des Saure-Basen-Haushaltes besprochen. Weiterhin werden — sofern entsprechende Untersuchungen vorliegen — die Auswirkungen der jeweiligen Elektrolytstorungen auf weitere Partialfunktionen der Nieren (Glomerulusfiltrat, Glucoseruckresorption, Ausscheidung organischer Sauren) angegeben. Bei den einzelnen Funktionsstorungen werden die zugrunde liegenden pathophysiologischen Mechanismen erortert, soweit sie sich aus experimentellen Befunden (Mikropunktionsuntersuchungen) ableiten lassen.

Fluid Therapy and Disorders of Electrolyte Balance

Medical Journal of AustraliaVolume 1, Issue 4 p. 139-139 Review Fluid Therapy and Disorders of Electrolyte Balance First published: 01 January 1966 https://doi.org/10.5694/j.1326-5377.1966.tb19560.xAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article. Volume1, Issue4January 1966Pages 139-139 RelatedInformation

Fluid Therapy and Disorders of Electrolyte Balance.

Dr. W. H. Taylor, the author of this volume, is Consulting Chemical Pathologist in charge of the Department of Chemical Pathology, the United Liverpool Hospitals, Director of Studies in Chemical Pathology, University of Liverpool, and tutor in Natural Science at St. Peter's College, University of Oxford. The purpose of this book is clearly stated in the preface where the author suggests that it shall meet the immediate and essential demands of doctors and students in their daily hospital practice. The book is divided into five sections. In the first section, Dr. Taylor deals with disorders of water and electrolyte balance. The syndromes concerned with a deficiency or an excess of water, sodium, magnesium, and potassium are presented as well as acid-base disturbances and metabolic response to injury and shock. These syndromes are discussed using the same outline, ie, etiological considerations, the clinical picture, and laboratory investigations. The second section deals

Essentials of Fluid Balance. Body Fluids and the Acid-Base Balance. A Guide to Learning Fluid Therapy. Fluid Therapy and Disorders of Electrolyte Balance. An Introduction to Body Fluid Metabolism.

Essentials of Fluid Balance. Body Fluids and the Acid-Base Balance. A Guide to Learning Fluid Therapy. Fluid Therapy and Disorders of Electrolyte Balance. An Introduction to Body Fluid Metabolism.

Book Review: Fluid Therapy and Disorders of Electrolyte Balance

Book Review: Fluid Therapy and Disorders of Electrolyte Balance