N5PAFL82
type: UserItem
resource: Acid-base and electrolyte disorders in patients with hyperglycaemia: a monocentric, observational study
tagged: UserTag
  label: *Acid-Base Equilibrium
tagged: UserTag
  label: *Acid-Base Imbalance/blood/diagnosis/epidemiology/mortality
tagged: UserTag
  label: *Hyperglycemia/blood/mortality/diagnosis/epidemiology
tagged: UserTag
  label: *Water-Electrolyte Imbalance/epidemiology/blood/diagnosis/mortality
tagged: UserTag
  label: Acid-base homeostasis
tagged: UserTag
  label: Adult
tagged: UserTag
  label: Aged
tagged: UserTag
  label: Aged, 80 and over
tagged: UserTag
  label: Bicarbonates/blood
tagged: UserTag
  label: Biomarkers/blood
tagged: UserTag
  label: Blood Gas Analysis
tagged: UserTag
  label: Blood Glucose/metabolism
tagged: UserTag
  label: Diabetic ketoacidosis
tagged: UserTag
  label: Electrolytes/blood
tagged: UserTag
  label: Female
tagged: UserTag
  label: Humans
tagged: UserTag
  label: Hyperosmolar hyperglycaemic state
tagged: UserTag
  label: Male
tagged: UserTag
  label: Middle Aged
tagged: UserTag
  label: Mortality
tagged: UserTag
  label: Osmolality
tagged: UserTag
  label: Osmolar Concentration
tagged: UserTag
  label: Prevalence
tagged: UserTag
  label: Retrospective Studies
tagged: UserTag
  label: conflict of interest. Ethical approval: This study was approved by the local
tagged: UserTag
  label: ethical committee of the City of Vienna (EK 23-187-VK).

Acid-base and electrolyte disorders in patients with hyperglycaemia: a monocentric, observational study
type: AcademicArticle
abstract: BACKGROUND: Acute hyperglycaemia is often accompanied by acid-base and electrolyte disorders as well as changes in serum osmolality which have a significant clinical impact. This study explores the prevalence of complex acid-base disorders in patients with hyperglycaemia, focusing on the limitations of current diagnostic criteria which primarily rely on pH, serum bicarbonate and anion gap. METHODS: A retrospective analysis of 1159 episodes of severe hyperglycaemia was performed. Arterial blood gas analysis, serum osmolality and electrolyte levels were measured at admission to hospital and patient's outcome was observed until day seven. Patients were evaluated for acid-base and electrolyte disorders as well as for changes in measured or calculated serum osmolality. RESULTS: Our findings reveal that 90.7% of patients exhibited some form of acid-base disorder, mixed acid-base disorders were the most prevalent (75%). Patients with an accompanying respiratory acidosis showed higher mortality rates (12%) than patients with respiratory alkalosis (6%, p = 0.006) or no respiratory disorder (5%, p = 0.003). An elevated serum osmolality was associated with higher mortality when using the calculated, effective osmolality (19% vs 4%, p < 0.001) as well as the measured osmolality (10% vs 4%, p = 0.001). Only 20% of our population had no electrolyte disorder. This group had a significantly lower mortality rate (2%) compared to patients with elevated or decreased sodium, potassium and phosphate levels. CONCLUSION: Patients with severe hyperglycaemia often had complex acid-base and electrolyte disorders but current criteria for diagnosing diabetic ketoacidosis (DKA) and hyperosmolar hyperglycaemic state (HHS) ignore combined disorders of acid-base homeostasis, potentially influencing patient management and outcomes.
pages: 1803-1811
doi: 10.1007/s10157-025-02738-0
source: 40810833
creator: Person
author list: Person
is part of: Issue
  date: 2025-08-14
  volume: 29
  issue: 12
  is part of: Journal
    issn: 1437-7799 (Electronic)

Person
given name: C.
surname: Schwarz

Person
given name: F.
surname: Ruttinger

Person
given name: G. C.
surname: Funk

Person
given name: G.
surname: Lindner

Person
given name: R.
surname: Edlinger

Person
given name: M.
surname: Auinger

Person
given name: T.
surname: Stulnig