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Acid-base and electrolyte abnormalities in patients with acute leukemia
H J Milionis1, C L Bourantas, K C Siamopoulos
1Department of Internal Medicine, Medical School, University of Ioannina, Greece.
American Journal of Hematology
|December 10, 1999
Summary
Electrolyte imbalances and acid-base disturbances are common in acute leukemia patients. Hypokalemia, often due to inappropriate kaliuresis, is the most frequent abnormality and may indicate other concurrent issues, particularly in acute myeloid leukemia.
Area of Science:
- Hematology
- Nephrology
- Clinical Biochemistry
Background:
- Acid-base balance and electrolyte abnormalities are frequent complications in acute leukemia.
- Understanding the pathogenesis of these disturbances is crucial for patient management.
Purpose of the Study:
- To investigate the mechanisms of acid-base and electrolyte disturbances in newly admitted acute leukemia patients.
- To identify the most common abnormalities and their interrelationships.
Main Methods:
- A cohort of 66 adult patients with acute leukemia (acute myeloid leukemia and acute lymphoblastic leukemia) was studied before treatment.
- Patients with confounding conditions or medications were excluded.
- Acid-base status and electrolyte parameters were analyzed upon admission.
Main Results:
- 41 patients (63%) exhibited at least one acid-base or electrolyte disturbance.
- Hypokalemia was the most prevalent abnormality (63%), observed in 34 AML and 7 ALL patients, primarily due to inappropriate kaliuresis.
- Hypokalemic patients had a higher incidence of concurrent electrolyte (hyponatremia, hypocalcemia, hypophosphatemia, hypomagnesemia) and acid-base disturbances.
Conclusions:
- Hypokalemia is a common finding in acute leukemia and is associated with multiple, interrelated electrolyte and acid-base abnormalities.
- Hypokalemia may serve as a marker for more complex metabolic derangements, especially in acute myeloid leukemia patients.