ĐẶC ĐIỂM CỦA RỐI LOẠN ĐIỆN GIẢI TRÊN NGƯỜI BỆNH SUY THƯỢNG THẬN DO DÙNG GLUCOCORTICOID

Abstract

Objective: Describe the characteristics of electrolyte disturbances (Na+, K+ in blood) in patients with adrenal insufficiency due to glucocorticoid use at Bach Mai Hospital in 2024-2025. Subjects and methods: Cross-sectional, prospective descriptive study on 55 patients diagnosed with adrenal insufficiency with electrolyte disturbances due to GCs use at Bach Mai Hospital from December 2024 to June 2025. Results: Female/male sex ratio = 1/1,73. Average age is 64,87 years old. Type of Glucocorticoid drug used: Hydrocortisone (31,3%), other drugs (28,1% tablets), Methylprednisone (15,6%), Prednisone (14,1%), Dexamethasone (9,8%). Rate of patients: hyponatremia (62%), hyperkalemia (8%), hypokalemia (30%). In patients with hyponatremia: with clinical symptoms (59,5%), without clinical symptoms (40,5%). Average Na concentration: 125±8,9 mmol/l. In patients with hypokalemia: Average K concentration: 2,88±0.39 mmol/l, of which 33.3% of patients had ECG changes. In patients with hyperkalemia: Average K concentration: 5,46±0.33 mmol/l, with ECG changes in 20%. Conclusion: Electrolyte disorders in patients with adrenal insufficiency due to Glucocorticoids are common in men, often occurring in middle age, including hyponatremia, hypokalemia, hyperkalemia, mainly hyponatremia. The types of GCs used are diverse, but mainly concentrated and hydrocortisone. In patients with hyponatremia, most have clinical symptoms. In patients with hypokalemia, only a part recorded ECG changes. In contrast, in patients with hyperkalemia, ECG changes were noted predominantly.