Electrolyte Disturbances In Patients Research Articles

Electrolyte disturbances in patients hospitalized for COVID-19 infection: An observational study.

There are multiple mechanisms by which The Coronavirus-19 (COVID-19) infection can cause electrolyte abnormalities, which may not be the case for bacterial causes of pneumonia. This study aimed to assess the differences in electrolyte levels between patients suffering from COVID-19 and bacterial pneumonia. This is an original, retrospective study. Two cohorts of hospitalized patients were included, 1 suffering from COVID-19 and the other from bacterial pneumonia. Their day 1 and day 3 levels of sodium, potassium, magnesium, and phosphorus, as well as their outcomes, were extracted from the charts. Statistical analysis was subsequently performed. Mean admission levels of sodium, potassium, phosphorus, and magnesium were 135.64 ± 6.13, 4.38 ± 0.69, 3.53 ± 0.69, and 2.03 ± 0.51, respectively. The mean day 3 levels of these electrolytes were 138.3 ± 5.06, 4.18 ± 0.59, 3.578 ± 0.59, and 2.11 ± 0.64, respectively. Patients suffering from bacterial pneumonia were significantly older (N = 219, mean = 64.88 ± 15.99) than patients with COVID-19 pneumonia (N = 240, mean = 57.63 ± 17.87). Bacterial pneumonia group had significantly higher serum potassium (N = 211, mean = 4.51 ± 0.76), and magnesium (N = 115, mean = 2.12 ± 0.60) levels compared to COVID-19 group (N = 227, mean = 4.254 ± 0.60 for potassium and N = 118, mean = 1.933 ± 0.38 for magnesium). Only magnesium was significantly higher among day 3 electrolytes in the bacterial pneumonia group. No significant association between electrolyte levels and outcomes was seen. We found that COVID-19 patients had lower potassium and magnesium levels on admission, possibly due to the effect of COVID-19 on the renin-angiotensin-aldosterone system as well as patient characteristics and management. We did not find enough evidence to recommend using electrolyte levels as a determinator of prognosis, but more research is needed.

Predictive value of hyponatremia for short-term mortality in supratentorial spontaneous intracerebral hemorrhage: a single center study

BackgroundHyponatremia is a common electrolyte disturbance in patients with neurological disease; however, its predictive role for outcome in patients with supratentorial spontaneous intracerebral hemorrhage (sICH) is controversial. This study aims to explore the association between hyponatremia within 7 days after bleeding and 90-day mortality in patients with supratentorial sICH.MethodsA retrospective analysis was conducted at our institution. Patients with sICH meeting the inclusion criteria were enrolled in this study. Multivariate regression analyses were performed to determine the predictive value of hyponatremia (serum sodium <135 mmol/L) for 90-day mortality and functional outcome. Subgroup analysis was performed based on the degree and duration of hyponatremia and therapeutic strategies. The Spearman correlation test was performed to explore the relationship between hyponatremia severity and duration with variables in a multivariate regression model. Kaplan–Meier curve was depicted to reveal the relationship between hyponatremia and mortality. The receiver operating characteristic (ROC) curve was plotted to show the diagnostic effect of the minimum concentration of serum sodium (sodiummin) on 90-day mortality.ResultsA total of 960 patients were enrolled, 19.6% (188) of whom were patients with hyponatremia and 26.0% (250) had 90-day mortality. The incidence of hyponatremia was roughly 2.5 times in non-survivors compared with survivors (34.8% vs. 14.2%). Multivariate regression analysis revealed that hyponatremia was the independent predictor of 90-day mortality (OR 2.763, 95%CI 1.836–4.157) and adverse outcome (OR 3.579, 95%CI 2.332–6.780). Subgroup analysis indicated an increased trend in mortality risk with both duration (more or less than 48 h) and severity of hyponatremia (mild, moderate, and severe) and confirmed the predictive value of hyponatremia for mortality in patients undergoing surgical intervention (external ventricular drainage, craniotomy, and decompressive craniectomy; all p < 0.05). The Spearman correlation test indicated no moderate or strong relationship between hyponatremia severity and duration with other variables in the multivariate model (all |rs| < 0.4). The ROC curve suggested the moderate diagnostic performance of sodiummin for mortality in both general patients and subgroups of therapeutic method patients (AUC from 0.6475 to 0.7384).ConclusionHyponatremia occurring in the first 7 days after bleeding is an independent predictor of 90-day morality and adverse outcome. Rigorous electrolyte scrutiny in patients treated surgically is required.

Electrolyte Disturbance with Severity of Dengue Infected Patient. A Study in Jhalawar Medical College & SRG Hospital, Jhalawar, Rajasthan

Background: Dengue is considered to be the most rapidly spreading mosquito borne viral disease in the world. The dengue viruses are members of the genus Flavivirus and family Flaviviridae. Electrolyte imbalance is commonly encountered in this disease. There had been only a few worldwide research studies investigated on electrolyte disturbances with severity of dengue infection. Methods: Cross sectional prospective study was carried out in medicine department of Jhalawar Medical College & SRG Hospital, Jhalawar, Rajasthan. All cases of dengue confirmed by detection of either NS1Ag or IgM/IgG by ELISA method during study period will be included in study. This study was conducted to find relation between electrolyte disturbances in patients with dengue fever. Results: Out of 90 patients, majority i.e. 48 (53.3%) patients in total had mild hyponatremia, 37 (41.1%) had normal and 3 (3.33%) and 2(2.22%) patients had moderate, severe hyponatremia respectively. The prevalence of dengue patients with hyponatremia was 58.9 % in the present study. Out of 90,77 Dengue fever patients, 32(41.6%) had normal, 45(58.4%) had mild decrease in sodium level. Out of 90, 50 (55.6%) having normal potassium,32(35.6%) were mild decrease in level,4 cases(4.5%) were moderate and 1(1.1%) were severe and 3(3.3%) had Hyperkalaemia. Conclusion: This study provides an insight regarding Electrolyte Disturbance With Severity Of Dengue Infected Patient. Considering the variations in serum electrolyte levels in patients of dengue and high incidence of dengue in India, it is necessary to have a degree of suspicion in patients of dengue about electrolyte disturbances and treat them accordingly.

The Clinical Characteristics of Electrolyte Disturbance in Patients with Moderate and Severe Traumatic Brain Injury Who Underwent Craniotomy and Its Influence on Prognosis.

The present study aimed to investigate the clinical characteristics of electrolyte imbalance in patients with moderate to severe traumatic brain injury (TBI) who underwent craniotomy and its influence on prognosis. A total of 156 patients with moderate to severe TBI were prospectively collected from June 2019 to June 2021. All patients underwent craniotomy and intracranial pressure (ICP) monitoring. We aimed to explore the clinical characteristics of electrolyte disturbance and to analyze the influence of electrolyte disturbance on prognosis. A total of 156 patients with moderate and severe TBI were included. There were 57 cases of hypernatremia, accounting for 36.538%, with the average level of 155.788±7.686 mmol/L, which occurred 2.2±0.3 days after injury. There were 25 cases of hyponatremia, accounting for 16.026%, with the average level of 131.204±3.708 mmol/L, which occurred 10.2±3.3 days after injury. There were three cases of hyperkalemia, accounting for 1.923%, with the average level of 7.140±1.297 mmol/L, which occurred 5.3±0.2 days after injury. There were 75 cases of hypokalemia, accounting for 48.077%, with the average level of 3.071±0.302 mmol/L, which occurred 1.8±0.6 days after injury. There were 105 cases of hypocalcemia, accounting for 67.308%, with the average level of 1.846±0.104 mmol/L, which occurred 1.6±0.2 days after injury. There were 17 cases of hypermagnesemia, accounting for 10.897%, with the average level of 1.213±0.426 mmol/L, which occurred 1.8±0.5 days after injury. There were 99 cases of hypomagnesemia, accounting for 63.462%, with the average level of 0.652±0.061 mmol/L, which occurred 1.3±0.4 days after injury. Univariate regression analysis revealed that age, Glasgow coma scale (GCS) score at admission, pupil changes, ICP, hypernatremia, hypocalcemia, hypernatremia combined with hypocalcemia, epilepsy, cerebral infarction, severe hypoproteinemia were statistically abnormal (p<0.05), while gender, hyponatremia, potassium, magnesium, intracranial infection, pneumonia, allogeneic blood transfusion, hypertension, diabetes, abnormal liver function, and abnormal renal function were not statistically significant (p>0.05). After adjusting gender, age, GCS, pupil changes, ICP, epilepsy, cerebral infarction, severe hypoproteinemia, multivariate logistic regression analysis revealed that hypernatremia or hypocalcemia was not statistically significant, while hypernatremia combined with hypocalcemia was statistically significant (p<0.05). The incidence of hypocalcemia was the highest, followed by hypomagnesemia, hypokalemia, hypernatremia, hyponatremia and hypermagnesemia. Hypocalcemia, hypomagnesemia, and hypokalemia generally occurred in the early post-TBI period, hypernatremia occurred in the peak period of ICP, and hyponatremia mostly occurred in the late period after decreased ICP. Hypernatremia combined with hypocalcemia was associated with prognosis.

Electrolyte Disturbance in Patients with Head Injury in Neuro ICU, EMCH, Savar, Dhaka, Bangladesh

Background: A head injury is a broad term that describes a vast array of injuries that occur to the scalp, skull, brain, and underlying tissue and blood vessels in the head. Head injuries are also commonly referred to as brain injury or traumatic brain injury (TBI), depending on the extent of the head trauma. Serum electrolyte abnormalities (SEAs) may occur due to the initiation of destructive inflammatory and biochemical cascades of primary brain injury or as a result of interventions such as hyperosmolar therapy. Objective: To evaluate the electrolyte disturbance in patients with head injury in Neuro ICU, Enam Medical College &amp; Hospital, Savar, Dhaka, Bangladesh. Methodology: It was cross sectional observational study carried out by Department of Neuro ICU, Dhaka during the period of 2017-2021. Total 37 head injury patients were included. Data were collected using a structured questionnaire containing all the variables of interest. Data was processed and analyzed with the help of computer program SPSS for windows version 25. Results: This study shows maximum (45.9%) were 15-35 years. The mean age was 30.97±18.49 years (range 2 years-71 years). Majority (94.6%) were male and only 5.4% were female. Most common head injury were due to road traffic accident (75.7%), followed by fall from height which contributes 56 (18.9%). Among 37 patients 28 (75.7%) patients normal serum sodium level, hyponatremia seen in 7 (18.9%) patients and 2 (5.4%) had hypernatremia. Hypokalemia observed in 21 (56.8%) patients, hyperkalemia in 7 (18.9) patients and 9 (24.3%) patients had normal potassium level. Hypochloremia were present in 21 (56.8%) patients, hyperchloremia in 7 (18.9%) patients and in 9 (24.3%) patients no change in serum chloride. Conclusion: Serum sodium, potassium and chloride abnormalities are common in head injury patients in this study. They are associated with higher risk of mortality and can be expected to occur in patients with abnormalities in specific clinical, radiological and acid-based parameters.

Nutritional Assessment and Management in Paediatric Chronic Kidney Disease.

Nutrition in paediatrics has always been one of the most important factors for optimal growth. Children with chronic kidney disease (CKD) need special consideration for better long-term outcomes, including nutritional status, optimal height, and cognitive function. Nonetheless, there are many obstacles to overcome to attain optimal linear growth and nutritional status in children with CKD. This review highlights the need for tools to assess the growth parameters in CKD. In addition, recommendations for dietary intake play a major role in controlling electrolyte disturbances in patients with CKD. For example, it is still unclear whether it is better to restrict phosphate sources in inorganic, organic, or food additives. The review also summarises different factors such as fluid intake, route of feeding, and essential nutrients that require particular attention in paediatric patients with CKD. In summary, a multidisciplinary team is needed to devise individual nutritional plans to achieve the best outcome and improve the quality of life of patients.

Frequency of Electrolyte Imbalance in Patients Presenting With Acute Stroke.

IntroductionElectrolyte disturbances are commonly reported in acute stroke in studies conducted in the western world. Presently, the data available about the prevalence of electrolyte disturbance in patients with stroke are not sufficient, especially from developing countries. The purpose of our study is to determine the frequency of occurrence of electrolyte imbalance in patients presenting with acute stroke in a tertiary care hospital.MethodsThis descriptive cross-sectional study was conducted in the department of internal medicine and neurology in a tertiary care hospital, Pakistan, from December 2019 to March 2021. A total of 300 patients, aged between 30 and 70 years, with either ischemic or hemorrhagic stroke, as diagnosed on contrast tomography (CT) scan of the head or magnetic resonance imaging (MRI) of the brain, were enrolled in the study. The biochemical analysis of the stroke patients was done.ResultsOut of the 300 participants, 139 (46.3%) participants were from the ischemic stroke group while 161 (53.7%) were from the hemorrhagic stroke group. The mean sodium level was significantly lower in the ischemic group as compared to the hemorrhagic group (129.41 ± 3.12 mEq/L vs. 134.42 ± 3.46 mEq/L; p-value: <0.0001). Potassium level was significantly higher in the hemorrhagic group compared to the ischemic group (6.27 ± 1.12 mmol vs. 4.31 ± 0.71 mmol; p-value: <0.0001).ConclusionPatients coming to emergency with stroke should be screened immediately for electrolyte imbalance. Early identification of rapid imbalances of serum electrolytes may aid in prompt medical intervention and resultant improved outcomes in stroke patients. It is crucial that electrolyte imbalances in these patients are closely monitored to avoid any complications.

Relationship of Hypocalciamia and Severity of Disease in COVID-19 Patients in Lahore Pakistan

Introduction: In Pakistan, a wave of coronavirus has started in February which was first reported in Wahun City China. Abnormal calcium blood level is considered one of the important and common electrolyte disturbances in patients with severe infection. The effect of blood calcium level on the severity of COVID-19 and the possible immune regulation mechanism is considered to be an important factor related to severity of disease. Aim of the Study: To find out the correlation of blood calcium levels and related risk factors of patients suffering from COVID-19 and provide a basis for early intervention in patients with relevant clinical characteristics and further reduce the incidence of critical illness and mortality in COVID-19 patients. Method: 180 COVID-19 patients were admitted to Gulab Devi Teaching Hospital, Lahore between February to July 2020. Subject index were tested on real-time fluorescent RT-PCR test. On the basis of the result of RT-PCR, they were divided into two groups according to clinical symptoms as mild (control/placebo group) and critical (experimental group). The patient with the mild symptom were included in the placebo group, whereas patient with the severe symptoms were included in the experimental group. Exclusion criteria: The patients who do not show the detection level of viral infection with the RT-PCR are excluded from the study. Results: The comparison has been carried out between the placebo group and the experimental group on the basis of various parameters. The patients serum calcium level was tested and the value for hypocalcemia was declared as per universal recommendation which is < 2.13mmol/L. According to the corrected serum total calcium level, COVID-19 patients can be divided into hypocalcemia group and normal blood calcium group. The result showed that hypocalcemia and immune dysfunction was found high in experimental group as compare to control group which shows a strong correlation between hypocalcemia and COVID-19 disease. Conclusion: It has been concluded from the study that patients with COVID-19 have obvious hypocalcemia and immune dysfunction, especially in experimental group patients. In this study, it is easy to be combined with multiple infections caused by pathogenic bacteria under certain conditions. Close monitoring of blood calcium levels can predict the severity of the disease more effectively.

Electrolyte disorders in stable renal allograft recipients.

Acid base and electrolyte disorders are frequently reported in the early period after renal transplantation. No comprehensive data exist on the prevalence and patterns of, and contributing factors to, electrolyte disturbances in patients with stable long-term allograft function. We analysed 576 renal transplant recipients (serum creatinine level &lt;2.0 mg/dl) in a cross-sectional study to evaluate the prevalence of electrolyte disorders and the risk factors associated with their occurrence. A total of 369 patients (64%) of all allograft recipients (n = 576) showed at least one electrolyte and acid base disorder. The most abundant disorder was hypomagnesaemia (25%, n = 143), followed by hyperkalaemia (12.8%, n = 74), hypercalcaemia (12%, n = 69), hypophosphataemia (11.6%, n = 67), metabolic acidosis (11.1%, n = 61) and hyponatraemia (9%, n = 52). All other electrolyte disorders were rare (&lt;6%). In most cases the electrolyte disorders could be classified as mild. Forty percent of the cases had a combined disorder, but without a preferential pattern of combinations. In a multivariate logistic regression analysis, the most important factors contributing significantly to the occurrence of electrolyte disorders were renal function and concomitant medications. Acid base and electrolyte disorders are frequently observed in stable renal allograft recipients, but are usually mild. A combination of two or more electrolyte abnormalities often occurs, although no predominant pattern of a unique combination of electrolyte disorder is recognizable. &nbsp.

Hypokalemia and hyperkalemia in patients on peritoneal dialysis: incidence and associated factors.

Hypokalemia is a well-described electrolyte disturbance in patients on peritoneal dialysis (PD). Hyperkalemia, however, is still overlooked, although it also represents a risk factor for mortality. Angiotensin-converting enzyme inhibitors and/or angiotensin receptor blockers (ACE/ARB), diuretics, and proton pump inhibitor (PPI) can interfere with potassium levels in these patients. This is a retrospective study that evaluated monthly serum potassium in a 5-year period. Serum potassium disturbances were evaluated as time-average and number of hypo- and hyperkalemia episodes per patient. Prescribed medication such as ACE/ARB, diuretics, and omeprazole were recorded. We evaluated 2025 potassium measurements obtained from 146 patients on PD. Serum potassium ranged from 2.5 to 8.3mEq/L with an average of 4.72 ± 0.74mEq/L. Hypokalemia was found in 59 measurements (2.9%) obtained from 35 patients (23.9%) whereas hyperkalemia was demonstrated in 269 (13.3%) measurements obtained from 74 patients (50.7%). Hypokalemia was associated with low albumin (p = 0.022), and omeprazole use (p = 0.024).Black race was aprotector factor (p=0.031). Omeprazole-associated hypokalemia was seen only in non-anuric patients and remained an independent risk factor even after adjustments. Patients who had hyperkalemia were more likely to be anuric (p = 0.001) and in use of furosemide (p = 0.0001). Hyperkalemia and hypokalemia are very frequent in patients on PD and should be closely monitored. Interventional studies should address the impact of discontinuing omeprazole in the levels of potassium.

Hyponatraemia aggravates cardiac susceptibility to ischaemia/reperfusion injury.

Hyponatraemia is defined as a serum sodium concentration of <135mEql/L and is the most common electrolyte disturbance in patients with chronic heart failure. We hypothesize that hyponatraemia may induce Ca2+ overload and enhance reactive oxygen species (ROS) production, which will exacerbate myocardial injury more than normonatraemia. We investigated the effect of hyponatraemia on the ability of the heart to recover from ischaemia/reperfusion episodes. Cardiomyocytes were obtained from 1- to 3-day-old Sprague Dawley rats. After isolation, cardiomyocytes were placed in Dulbecco's modified Eagle's medium (DMEM) containing low sodium concentration (110, 120, or 130mEq/L) or normal sodium concentration (140mEq/L) for 72hours. Exposure of cardiomyocytes to each of the low-sodium medium significantly increased both ROS and intracellular Ca2+ levels compared with the exposure to the normal-sodium medium. In vivo, 8-week-old male Sprague Dawley rats were divided into four groups: control group (Con), furosemide group (Fur), low-sodium diet group (Lsd) and both furosemide and low-sodium diet group (Fur+Lsd). The hearts subjected to global ischaemia exhibited considerable decrease in left ventricular developed pressure during reperfusion, and the size of infarcts induced by ischaemia/reperfusion significantly increased in the Fur, Lsd and Fur+Lsd compared with that in the Con. Hyponatraemia aggravates cardiac susceptibility to ischaemia/reperfusion injury by Ca2+ overload and increasing in ROS levels.

A common but forgotten cause of electrolyte disturbances in patients with cachexia

Searchable abstracts of presentations at key conferences in endocrinology ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Electrolyte Disturbances in Acute Exacerbation of COPD

Background: Chronic obstructive pulmonary disease (COPD) is a major cause of chronic morbidity and mortality worldwide. Acute exacerbation is an acute and sustained worsening of a patient’s condition from a stable state and it is associated with significant electrolyte disturbances.&#x0D; Objectives: The main objective of this study was to determine the prevalence of electrolyte disturbances in patients with acute exacerbation of COPD and to determine possible effects of these electrolyte disorders.&#x0D; Materials and Methods: This observational prospective study was carried out in the Department of Pulmonology, Enam Medical College &amp; Hospital from 1st January to 31st December 2017. Sixty patients with acute exacerbation of COPD were included. Serum electrolytes and arterial blood gases were measured.&#x0D; Results: Low level of serum sodium (131 ± 5.66 mEq/L) and potassium (3.20 ± 0.44 mEq/L) were found in subjects with acute exacerbation of COPD. In patients with respiratory failure Na+ and K+ levels were even lower.&#x0D; Conclusion: Serum electrolytes in acute exacerbation of COPD patients should be monitored routinely and should be corrected early to avoid poor outcomes.&#x0D; J Enam Med Col 2019; 9(1): 25-29

Electrolyte disturbances in patients with acute exacerbation of chronic obstructive pulmonary disease

Introduction Chronic obstructive pulmonary disease (COPD) is a cover term that includes a variety of progressively debilitating lung diseases. COPD includes both emphysema and chronic bronchitis. Although COPD is mainly a chronic disease, a substantial number of patients experience exacerbations that are related to a significantly worse survival outcome, especially with abnormal serum electrolyte level. Aim To detect the serum electrolytes disturbances in patients with acute exacerbation of COPD. Patients and methods A prospective study was conducted at Chest Department, El-Hussein University Hospital, Al Azhar University, on patients with acute exacerbation of COPD. The study was approved by the hospital ethics committee, and a written consent was obtained from each patient before the procedure. Results We found a significantly low level of serum sodium (Na) (131±4.45 mEq/l), potassium (3.19±0.96 mEq/l), magnesium (1.85±0.17 mEq/l), and chloride (84.75±7.31 mEq/l) in patients with acute exacerbation of COPD than their healthy controls (Na+=138±2.28 mEq/l, potassium=4.50±0.02 mEq/l, magnesium=2.20±0.14 mEq/l and chloride=100.30±2.67 mEq/l) (P&lt;0.05). Conclusion In patients with acute exacerbation of COPD, there are abnormal serum electrolytes like sodium, potassium, magnesium, and chloride levels.

Acid-base and electrolyte disturbances in patients with diabetes mellitus

ABSTRACT

Electrolyte disturbances in patients with acute exacerbation of bronchial asthma

Electrolyte disturbances in patients with acute exacerbation of bronchial asthma

Serum sodium level in dengue infected children: a retrospective study

Background: Dengue fever is one of the most common arbo virus mediated outbreaks, being reported from different parts of the world. Now as the outbreaks are hitting different geographic locations, different clinical manifestations are being reported recently. Aim of this study is to document the serum Sodium level in dengue infected children in a tertiary care centre.Methods: A total 128 cases of NS1 antigen, IgM positive or ELISA positive dengue patients were included in this observational study and analyzed.Results: The serum Sodium level in dengue varies according to the different groups. In group A (dengue with no warning signs) the serum Sodium level was normal, whereas in case of group B (dengue with warning signs), there was significant hyponatremia. In group C, severe dengue the serum Sodium was normalConclusions: Mild hyponatremia is a common electrolyte disturbance in patients with dengue with warning signs. Hence, the lower the serum Sodium levels the higher is the incidence of complications associated with dengue fever.

Electrolyte Disturbances in Patients with Diabetes Mellitus

Diabetic patients frequently develop a constellation of electrolyte disorders. These derangement results from insulin deficiency, hyperglycemia and hyperketonemia. Hyperglycemia sets the internal environment for osmotic diuresis while causing a dilutional effect on electrolyte concentrations.The osmotic effect of glucose results in decreased circulating blood volume and fluid shift from the intracellular spaces causing cellular dehydration. These disturbances are particularly common in decompensated diabetes, especially in the context of diabetic ketoacidosis or non ketotic hyperglycemic hyperosmolar syndrome.These patients are markedly sodium, magnesium and phosphate depleted. Diabetes mellitus is linked to both hypo and hyperkalemia and also hypo and hypercalcemia reflecting coexistence of hyperglycemia related mechanisms, which tend to change serum potassium and calcium to opposite directions. This article provides an overview of the electrolyte disturbances occurring in Diabetes and mechanisms underlying those disturbances.Bangladesh J Med Biochem 2017; 10(1): 27-35

Tips for management of arrhythmias in endocrine disorders from an European Heart Rhythm Association position paper.

In endocrine diseases, hormonal changes, electrolyte abnormalities, and the deterioration of heart structure can lead to various arrhythmias. In diabetic patients, hypoglycemia, hyperglycemia, and hypokalemia can trigger arrhythmias, and diabetic cardiomyopathy can also cause electrical and structural remodeling to form substrates for arrhythmias. The risk of atrial fibrillation (AF) increases in hyperthyroidism; however, the prevalence of ventricular arrhythmias in hypothyroidism is higher. Besides AF and ventricular tachycardias, bradycardias and atrioventricular blocks can also be seen in pheochromocytoma due to the desensitization of adrenergic cardiovascular receptors. The correction of metabolic and electrolyte disturbances in patients with adrenal cortex disease should be the main approach in the prevention and treatment of arrhythmias. Early initiation of treatment in patients with acromegaly seems to decrease the development of cardiac remodeling and ventricular arrhythmia. Early and late after depolarizations due to hypercalcemia in hyperparathyroidism can lead to life-threatening ventricular arrhythmias. This elegant position paper provides important recommendations regarding prevention and treatment of arrhythmias for specific endocrine disorders.

Correction of electrolyte disorders – a component of effective therapy of hypertension

The article deals with the role of the K+ and Mg2+ levels in the body of patients with arterial hypertension, the causes of the imbalance of these electrolytes are examined, the need for monitoring and correction of the K+ and Mg2+ levels is shown. In particular, the medication containing potassium aspartate and magnesium asparaginate (trade name Panangin) is the drug of choice for correction of electrolyte disturbances in patients with arterial hypertension, its inclusion in the complex therapy is pathogenetically justified for the purpose of more effective control of blood pressure