title: Electrolyte abnormalities and laboratory findings in patients with out-of-hospital cardiac arrest who have kidney disease.
abstract: OBJECTIVE
  Although electrolyte abnormalities have been generally considered the major cause of out-of-hospital cardiac arrest (OHCA) in patients with kidney disease (KD), this association has never been prospectively validated.
  
  
  METHODS
  A prospective, observational study was conducted in a tertiary university hospital between January 2008 and December 2009. The study sample consisted of consecutively admitted patients with nontraumatic OHCA. Based on the estimated glomerular filtration rate (eGFR, unit: milliliters per minute per 1.73 m(2)), the enrollees were divided into 3 groups: group A (normal kidney function or mild KD; eGFR, 60.0), group B (moderate KD; eGFR between 15.0 and 59.9), and group C (severe KD; eGFR<15.0 or on dialysis). The laboratory findings of the groups were compared. Two-tailed P values less than .005 were considered significant.
  
  
  RESULTS
  Two hundred thirty-four enrollees (137 were male) were divided into 3 groups: group A (n = 51; 21.8%), group B (n = 128; 54.7%), and group C (n = 55; 23.5%). Compared with the other 2 groups, group C presented significantly higher serum potassium and magnesium and lower pH and hemoglobin level (all P < .005). After stratifications of the significant variables, a post hoc analysis revealed that group C presented significantly higher incidences of hypermagnesemia (Mg >2.5 mmol/L) and severe hyperkalemia (K >6.5 mmol/L) (both P < .005) than the other 2 groups. The odds ratios of the incidence of severe hyperkalemia in group C was 3.37 (95% confidence intervals, 1.46-7.77) compared with group A (50.9% vs 23.5%, P < .005).
  
  
  CONCLUSIONS
  Severe hyperkalemia is common in patients with OHCA who have severe KD and should be considered during resuscitation for these patients.
authors.affiliation: Department of Emergency Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan. emergency.lin@gmail.com
authors.forename: Chih-Hao
authors.initials: CH
authors.lastname: Lin
authors.forename: Yi-Fang
authors.initials: YF
authors.lastname: Tu
authors.forename: Wen-Chu
authors.initials: WC
authors.lastname: Chiang
authors.forename: Shyu-Yu
authors.initials: SY
authors.lastname: Wu
authors.forename: Ying-Hsin
authors.initials: YH
authors.lastname: Chang
authors.forename: Chih-Hsien
authors.initials: CH
authors.lastname: Chi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D005260:Female; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D006947:Hyperkalemia / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology; D015994:Incidence; D007674:Kidney Diseases / Q000097:blood / Q000150:complications*; D008274:Magnesium / Q000097:blood; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D058687:Out-of-Hospital Cardiac Arrest / Q000097:blood / Q000209:etiology*; D011446:Prospective Studies; D012720:Severity of Illness Index; D014883:Water-Electrolyte Imbalance / Q000097:blood / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology
chemical_list: D015415:Biomarkers; D006454:Hemoglobins; D008274:Magnesium