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Electrolytes supplementation can decrease the risk of nephrotoxicity in patients with solid tumors undergoing chemotherapy with cisplatin.
Minzi, OMS, Lyimo, TE, Furia, FF, Marealle, AI, Kilonzi, M, Bwire, GM, Malichewe, C
BMC pharmacology & toxicology. 2020;(1):69
Abstract
BACKGROUND Cisplatin is an important drug in the treatment of various Cancers. However, this drug causes nephrotoxicity that is linked to electrolyte derangement. The aim of this study was to evaluate the effect of electrolyte supplementation in reducing kidney injury in patients receiving cisplatin-based regimen. METHODS This was non-randomized interventional study conducted at Ocean Road Cancer Institute (ORCI) among patients with confirmed solid tumors. Patients who received cisplatin-based chemotherapy at a dose of ≥50 mg with intravenous normal saline supplemented with Magnesium, Calcium and Potassium (triple electrolyte supplementation) were compared with those who received cisplatin-based chemotherapy with normal saline alone. The patients were followed up for 4 weeks and serum creatinine was measured at every visit. Nephrotoxicity was defined as serum creatinine elevation > 1.5 times that at baseline. RESULTS A total of 99 patients were recruited, whereby 49 patients (49.5%) received electrolyte supplementation (treatment group) and 50 patients (51.5%) did not receive electrolyte supplementation (control group). The incidence risk of nephrotoxicity was 20.41% (n = 10) in the treatment group and 54% (n = 27) in the control group. Patients in the control group were 2.6 times more likely to experience nephrotoxicity as compared to treatment group [Relative Risks (RR); 2.6, 95%CI; 1.5-4.9, P < 0.0001]. The most common malignancy was cervical cancer, n = 43 (87.8%) in treatment group and n = 45 (90.0%) in the control group (P = 0.590). The Kaplan-Meier analysis and the log-rank test revealed that electrolytes supplementation was associated with extended survival with less nephrotoxicity incidences [P = 0.0004; Hazard ratio (HR) 0.3149; 95% CI 0.165 to 0.6011]. CONCLUSIONS Electrolytes supplementation decreases the risk of nephrotoxicity after chemotherapy with cisplatin. A randomized controlled trial with a larger sample size is recommended to evaluate the robustness of these findings.
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Serum electrolyte concentrations and hydration status are not associated with exercise associated muscle cramping (EAMC) in distance runners.
Schwellnus, MP, Nicol, J, Laubscher, R, Noakes, TD
British journal of sports medicine. 2004;(4):488-92
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Abstract
OBJECTIVES To determine whether acute exercise associated muscle cramping (EAMC) in distance runners is related to changes in serum electrolyte concentrations and hydration status. METHODS A cohort of 72 runners participating in an ultra-distance road race was followed up for the development of EAMC. All subjects were weighed before and immediately after the race. Blood samples were taken before the race, immediately after the race, and 60 minutes after the race. Blood samples were analysed for glucose, protein, sodium, potassium, calcium, and magnesium concentrations, as well as serum osmolality, haemoglobin, and packed cell volume. Runners who suffered from acute EAMC during the race formed the cramp group (cramp, n = 21), while runners with no history of EAMC during the race formed the control group (control, n = 22). RESULTS There were no significant differences between the two groups for pre-race or post-race body weight, per cent change in body weight, blood volume, plasma volume, or red cell volume. The immediate post-race serum sodium concentration was significantly lower (p = 0.004) in the cramp group (mean (SD), 139.8 (3.1) mmol/l) than in the control group (142.3 (2.1) mmol/l). The immediate post-race serum magnesium concentration was significantly higher (p = 0.03) in the cramp group (0.73 (0.06) mmol/l) than in the control group (0.67 (0.08) mmol/l). CONCLUSIONS There are no clinically significant alterations in serum electrolyte concentrations and there is no alteration in hydration status in runners with EAMC participating in an ultra-distance race.
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Circadian organization of serum electrolytes in physiological aging.
Trotti, R, Rondanelli, M, Cuzzoni, G, Magnani, B, Gabanti, E, Ferrari, E
Functional neurology. 2003;(2):77-81
Abstract
Age-related structural and neurochemical changes occurring in the central nervous system have been related to changes in some rhythmometric parameters. In spite of their clinical importance, only a few studies have investigated the modifications over time of serum electrolytes in senescence. The aim of our study was to evaluate the circadian pattern of serum potassium, chloride, sodium, calcium and phosphorus in 30 clinically healthy elderly subjects, with no cognitive impairment, and to compare the findings with those given by 24 healthy young controls. The subjects were synchronized as regards their daily activities, sleeping/waking habits, time/quality of meals and dietary electrolyte intake. After an overnight fast, samples were taken beginning at 08.00 and every 4 h thereafter until 20.00, and every 2 h from 20.00 to 04.00. Both the young and the elderly subjects exhibited statistically significant circadian rhythms for all serum electrolytes considered. Our findings suggest that circadian organization of serum electrolytes is maintained in physiological aging, even though it should be noted that sodium and phosphorus acrophases differed significantly in the two experimental groups.
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Influence of a carbohydrate-electrolyte solution ingested during running on muscle glycogen utilisation in fed humans.
Chryssanthopoulos, C, Williams, C, Nowitz, A
International journal of sports medicine. 2002;(4):279-84
Abstract
This study investigated whether the ingestion of a carbohydrate-electrolyte solution during running would influence muscle glycogen utilisation in subjects who had consumed a carbohydrate meal 3 hours before exercise. Eight men completed two 60-min treadmill runs at 70% VO(2)max. Before each run they consumed a carbohydrate meal (183 +/- 7 g) 3 hours before exercise and either 1) a carbohydrate-electrolyte solution during the run (46 +/- 1 g) (M+C), or 2) water during the run (M + W). Biopsy samples were obtained from the vastus lateralis muscle at rest and after 60 min of running. Serum insulin concentrations were higher (p < 0.01) in both trials at the start of exercise compared with fasting values, whereas blood glucose concentrations were higher (p < 0.01) after 60 min of running in the M+C trial. Pre-exercise muscle glycogen concentrations were similar in both trials (M+C: 321.9 +/- 27.2 vs M+W: 338.8 +/- 32.8 mmol x kg x dry weight (-1) [dw]; NS). There was no difference in the amount of glycogen used during exercise (M+C: 96.1 +/- 22.1 vs M+W: 77.9 +/- 11.7 mmol x kg x dw (-1); NS). In conclusion, a carbohydrate-electrolyte solution ingested during treadmill running at 70 % VO(2)max does not influence muscle glycogen use during the first hour of exercise when a carbohydrate meal is consumed 3 hours before exercise.
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Short-term recovery from prolonged constant pace running in a warm environment: the effectiveness of a carbohydrate-electrolyte solution.
Bilzon, JL, Allsopp, AJ, Williams, C
European journal of applied physiology. 2000;(4):305-12
Abstract
Recovery from prolonged exercise involves both rehydration and replenishment of endogenous carbohydrate stores. This study examined the influence of drinking a carbohydrate-electrolyte solution on short-term recovery and subsequent exercise capacity in a warm environment. Thirteen healthy male volunteers completed two trials, at least 7 days apart. On each occasion subjects performed an initial treadmill run at 60% of maximal oxygen uptake (VO2max), for 90 min or until volitional fatigue (T1), in a warm environment (35 degrees C, 40% relative humidity, RH). Volitional ingestion of water was permitted during each of the exercise trials. During a subsequent 4-h recovery period (REC) subjects consumed either a 6.9% carbohydrate-electrolyte solution (CES) or a sweetened placebo (P), in a volume equivalent to 140% of body mass loss. Following REC, subjects ran to exhaustion at the same % VO2max in order to assess their endurance capacity (T2). Mean (SEM) run times during T1 did not differ between the CES [74.8 (4.6) min] and P [72.5 (5.2) min] trials. Body mass was reduced (P < 0.01) by 1.9 (0.2)% (CES) and 1.7 (0.2)% (P), and plasma volume (P < 0.01) by 6.0 (0.9)% (CES) and 5.4 (1.0)% (P) during the T1 trials. During REC 2006 (176) ml and 1830 (165) ml of fluid was ingested, providing 138 (12) g and 0 g of carbohydrate in the CES and P trials, respectively. Prior to T2, plasma volume and net fluid balance were similarly restored [CES +58 (26) g; P -4 (68) g] in both trials. During T2 the exercise duration was longer (P < 0.01) in the CES compared to the P trial [CES 60.9 (5.5) min; P 44.9 (3.0) min]. Thus, provided that an adequate hydration status is maintained, inclusion of carbohydrate within an oral rehydration solution will delay the onset of fatigue during a subsequent bout of prolonged submaximal running in a warm environment.