THE BASIC SERUM BLOOD ELECTROLYTES EXCHANGE PECULIARITIES IN MEN UNDER 60 YEARS OLD WITH MYOCARDIAL INFARCTION, COMPLICATED WITH ACUTE KIDNEY INJURY

Abstract

Background. Acute kidney injury (AKI) in myocardial infarction (MI) worsens its prognosis. Electrolyte changes in AKI in men under 60 years old (y.o.) has been insufficiently studied. Purposes and tasks. To assess changes in the levels of serum sodium, potassium, total calcium and chlorides in men under 60 y.о. in acute and subacute periods of MI with AKI to improve understanding of the mechanisms of complications to search for possible ways to improve prevention. Materials and methods. The study included men 19-60 y.o. with type I MI. The patients were divided into two age comparable groups: I - study group, with AKI - 20 patients; II - control, without AKI - 376 patients. A comparative assessment of the listed above blood serum electrolytes concentration in the first 48 hours and the end of the third week of MI, as well as their dynamics and relationships in these groups of patients, were performed. The results. The study group at the end of the third week of MI was characterized by a predominance of sodium concentration (143.3 ± 3.4 and 140.0 ± 4.3 mmol/l; p = 0.0004) and chlorides (104.6 ± 2.7 and 102.8 ± 3.3 mmol/l; p = 0.047) over the control. There were an increase in the level of electrolytes at the second observation point in both groups of patients (I: calcium (1.42 %; p = 0.0004); II: sodium (0.84 %; p < 0.0001), potassium (2.23 %; p < 0.0001), calcium (2.42 %; p = 0.005), chlorides (0.89 %; p = 0.02)). In the study group, significant correlations of moderate and strong tightness were revealed between the concentrations of the studied electrolytes and the parameters of the structural and functional heart state, peripheral hemodynamics, lipid, electrolyte, nitrogen metabolism, hemostasis, quality of life and the MI prognosis. Conclusions. Men under 60 y.о. with AKI and MI have high serum sodium and chloride levels at the end of the third week of illness, as well as spur increasing potassium levels. During this period, hypocalcemia is associated with a deterioration in the quality of life, and hypernatremia is associated with an unfavorable prognosis of the disease.