Analysis of risk factors of intracavitary treatment of hypokalemia in patients with urinary calculi

Abstract

Abstract Background: 30% of patients with hypokalemia develop ventricular tachycardia or ventricular fibrillation. Through clinical observation, we found that there are more patients with hypokalemia after surgical treatment of urinary calculi; as far as we know, there is no study on the changes of serum potassium after intracavitary treatment of urinary calculi. Objective: The change of electrolyte level through intracavitary treatment of urinary calculi (including URSL, PCNL, FURS combined with double endoscopy). To analyze the risk factors of hypokalemia and to provide evidence-based medical evidence for peri-operative management of intracavitary treatment of urinary calculi. Methods: 585 patients with urolithiasis (including URSL, MPCNL, FURS) from January 2020 to August 2021 were collected and analyzed. The relationship between age, sex, basic diseases, clinical manifestations, mode of operation, operation time, urinary leukocyte, urine culture, serum creatinine, electrolyte, location and size of urinary calculi and serum potassium were analyzed, and the independent risk factors were analyzed. Results: Among the 228 eligible patients, the proportion of women with HK was 63% higher than that of 37% in NG group, 3% in diabetic patients with HK, lower than that in NG group, 14.1% white blood cells in urine of HK (188.5 / ul) was higher than that of NG (96.4 / ul), and the serum creatinine (76mmol/L) before HK was lower than that of NG (85mmol/L). There was no significant difference between the two groups in age, BMI, basic diseases complicated with hypertension and coronary heart disease, clinical manifestations of low back pain and fever, positive urine culture before operation, anti-infection, blood magnesium, blood sodium, blood glucose, stone size, urine red blood cell count and operation time. Compared with men, women had diabetes. The OR values of ureteroscopy and flexible ureteroscope relative to percutaneous nephroscope and urinary leukocyte ≥ 120 / uL were 2.325, 7.793, 3.993, 2.09, respectively. Conclusion: Female, diabetes, ureteroscope, flexible ureteroscope and urinary calculi with elevated white blood cells may develop hypokalemia during the peri-operative period, so we should pay attention to blood potassium supplement.