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Metabolic Laboratory Data
Published in Michael M. Rothkopf, Jennifer C. Johnson, Optimizing Metabolic Status for the Hospitalized Patient, 2023
Michael M. Rothkopf, Jennifer C. Johnson
Monitoring the long-term PN or enteral patient is generally left to the outpatient part of our practice. But I’m including a mention of it here for completeness. As a basic overview, this order will be similar to our initial consult lab set. However, it is appropriate to consider adding more trace elements as well as an amino acid and fatty acid profile (see Table 8.1). Studies of carnitine and endocrine status are appropriate. Urine studies of electrolyte balance are also useful.
Physiologic Changes
Published in Vincenzo Berghella, Obstetric Evidence Based Guidelines, 2022
Pregnancy is associated with altered tubular function and therefore altered reabsorption of protein, glucose, amino acids, and uric acid. In contrast to tubular function, our knowledge of the factors that govern gestational changes in serum electrolytes is somewhat more definitive. Total body sodium increases on an average by 3–4 mEq/day, ultimately producing a net balance of 900–1000 mEq, and total body potassium also increase by up to 320 mEq by the end of gestation [40]. Despite the net increase in body stores of sodium and potassium (Table 3.1), serum levels of both electrolytes decrease during pregnancy (Table 3.2). Therefore, pregnancy is characterized by an increase in total body electrolyte stores, albeit with decreases in serum levels. Clinicians must recognize that increments in serum electrolytes that still fall within the normal range may constitute meaningful aberrations in electrolyte balance. Furthermore, conditions prone to either electrolyte retention or loss may be exacerbated during pregnancy [40].
Body fluids and electrolytes
Published in Peate Ian, Dutton Helen, Acute Nursing Care, 2020
A balance of electrolytes is essential for normal cellular function. As previously discussed, a disruption of fluid balance has consequences for serum electrolytes. Electrolyte imbalances can be caused by prolonged vomiting, diarrhoea, sweating or high fever, or hormonal or glucose imbalance, but also by the use of medicines such as diuretics, which influence both fluid and electrolyte balance.
COVID-19 and cardiovascular disease: manifestations, pathophysiology, vaccination, and long-term implication
Published in Current Medical Research and Opinion, 2022
Adel Abdel Moneim, Marwa A. Radwan, Ahmed I. Yousef
Maintaining an electrolyte balance is essential for normal cardiovascular health. High sodium and low potassium levels are both related to increased hypertension84. Increased resting blood pressure is associated with the risk of developing cardiovascular disease85. An early epidemiological study revealed that hypertension is frequent among patients with COVID-19 and is related to disease severity86. Moreover, electrolyte imbalances have been connected to COVID-19 in several investigations. Lippi et al. performed a meta-analysis to determine the relationship between electrolyte abnormalities and the severity of COVID-19. They observed that hypokalemia, hypernatremia, and hypocalcemia were correlated to the severity of COVID-19. Physiologically, angiotensin II (Ang II) type 1 receptor promotes renal sodium and water reabsorption and is activated by Ang II. Moreover, elevated aldosterone promotes higher urine potassium excretion87,88. Crop et al. recorded new-onset hypertension in patients with COVID-19 due to hypernatremia, hypokalemia, and increased activity of the renin–angiotensin–aldosterone system. Lastly, hypokalemia can cause ventricular arrhythmia that can sometimes be serious89 (Figure 1).
Histological and biochemical investigation of the renoprotective effects of metformin in diabetic and prostate cancer model
Published in Toxicology Mechanisms and Methods, 2021
Pınar Koroglu-Aydın, Bertan Boran Bayrak, Ilknur Bugan, Omur Karabulut-Bulan, Refiye Yanardag
MPO is a heme peroxidase expressed in neutrophils and monocytes. It is released by activated leukocytes and some tissue macrophages during inflammation (Davies and Hawkins, 2020). It is suggested that measurement of MPO activity under inflammatory conditions gives more sensitive results than histopathological examination of tissue (Faith et al. 2008). In addition, increased MPO activity is one of the best biochemical markers for diagnoses of diseases such as diabetes, cancer, chronic liver and kidney diseases (Khan et al. 2018). Na+/K+-ATPase is an integral membrane enzyme that is ubiquitously found in animals cells. It plays a crucial role in maintaining cells electrolyte balance. It is responsible for ion pumping functions such as exporting three Na+ ions and imports two K+ ions across the plasma membrane using the energy released during the hydrolysis of one ATP molecule to ADP and inorganic phosphate (Pi) (Kaločayová et al. 2015). In the current study, not only remarkable increase in MPO activities, but also a notable decrease in Na+/K+-ATPase activities of diabetic, cancer and DC animals was obsreved in comparison to control rats. Imbalance between oxidant and antioxidant status caused by overproduction of ROS may lead to escalation of MPO activity. In addition, exposure of kidney tissue to oxygen-derived free radicals may have caused a decrease in ATPase activity due to redox sensitivity (Srikanthan et al. 2016).
Data-driven quality assurance to prevent erroneous test results
Published in Critical Reviews in Clinical Laboratory Sciences, 2020
Bridgit O. Crews, Julia C. Drees, Dina N. Greene
Maintaining electrolyte balance in hospitalized or chronically ill patients requires accurate electrolyte measurements [5]. The laboratory is generally successful at achieving this. However, there are circumstances that lead to reporting erroneous electrolyte results, and this tends to be most problematic when measuring potassium [6,7]. The intracellular concentration of potassium is significantly higher than the surrounding plasma, which means that cellular lysis releases potassium at a concentration that can significantly alter the extracellular concentration. Cell turnover is ubiquitous within the body, but in a healthy individual Na+/K+ transporters and the renal circuitry maintain potassium balance. In contrast, several pathological states can disrupt the body’s ability to maintain potassium balance, leading to elevated circulating potassium, which can have severe medical consequences if not rapidly corrected [8]. Cell lysis in vitro will release significant amounts of potassium, posing a conundrum for the lab: how can laboratories differentiate cell lysis occurring in vitro from pathologies which may have increased potassium in vivo [9]?