Concentraciones séricas de potasio en preeclámpticas y embarazadas sanas

Serum potassium concentrations in preeclamptic and healthy pregnant women

Introducción: algunas investigaciones han propuesto que las alteraciones de las concentraciones séricas de potasio pueden contribuir a la aparición de hipertensión y a las alteraciones renales descritas en el síndrome de hipertensión inducida por el embarazo. Objetivo: comparar las concentraciones séricas de potasio en pacientes preeclámpticas y embarazadas normotensas sanas. Materiales y métodos: estudio de casos y controles entre enero 2014 y junio 2021 atendidas en el Hospital Central “Dr. Urquinaona”, Maracaibo, Venezuela. Se seleccionó un grupo con diagnóstico de preeclampsia (grupo A, casos) y otro control con embarazadas cuya edad materna e índice de masa corporal era similar al grupo de estudio (grupo B, controles). Se evaluaron las características demográficas, parámetros de laboratorio y concentraciones séricas de potasio. Resultados: se incluyeron un total de 515 embarazadas de las cuales 257 fueron asignadas al grupo A y 258 al B. Las del grupo A presentaron concentraciones séricas de potasio más bajos que las del B (p < 0,0001), cuyos valores solo se correlacionaron con los de creatinina sérica en el grupo de casos (p = 0,023). No se encontraron correlaciones significativas con los valores de presión arterial (p = ns). Conclusión: las pacientes preeclámpticas presentan menores concentraciones séricas significativas de potasio en comparación con las embarazadas normales.

1. Chourdakis E, Oikonomou N, Fouzas S, Hahalis G, Karatza AA. Preeclampsia emerging as a risk factor of cardiovascular disease in women. High Blood Press Cardiovasc Prev. 2021;28(2):103-114. https://doi.org/10.1007/s40292-020-00425-7.
2. Dines V, Kattah A. Hypertensive disorders of pregnancy. Adv Chronic Kidney Dis. 2020;27(6):531-539. https://doi.org/10.1053/j.ackd.2020.05.006.
3. Chappell LC, Cluver CA, Kingdom J, Tong S. Pre-eclampsia. Lancet. 2021;398(10297):341-354. https://doi.org/10.1016/S0140-6736(20)32335-7.
4. Murthi P, Brennecke SP. The placenta is the villain or victim in the pathogenesis of pre-eclampsia: FOR: The placenta is the villain in the pathogenesis of preeclampsia. BJOG. 2021;128(2):147. https://doi.org/10.1111/1471-0528.16537.
5. Pastén V, Tapia-Castillo A, Fardella CE, Leiva A, Carvajal CA. Aldosterone and renin concentrations were abnormally elevated in a cohort of normotensive pregnant women. Endocrine. 2022;75(3):899-906. https://doi.org/10.1007/s12020-021-02938-0.
6. Winarno GNA, Pribadi A, Maruli HJ, Achmad ED, Anwar R, Mose JC, Nisa AS, Trianasari N. Ratio of serum calcium to magnesium levels on pregnancy with and without preeclampsia. Med Sci Monit. 2021;27: e932032. https://doi.org/10.12659/MSM.932032.
7. Lenin A, Vijayaselvi R, Rajan SJ, Rathore S, Abraham K, Yadav B, Satyendra S. The impact of secondary hypertension in pregnancy on maternal and fetal outcomes: A 42-month observational study from South India. J Obstet Gynaecol India. 2022;72(Suppl 1):139-145. https://doi.org/10.1007/s13224-021-01576-w.
8. Kant S, Haldar P, Gupta A, Lohiya A. Serum calcium level among pregnant women and its association with pre-eclampsia and delivery outcomes: A cross-sectional study from North India. Nepal J Epidemiol. 2019;9(4):795-803. https://doi.org/10.3126/nje.v9i4.23150.
9. Ajong AB, Kenfack B, Ali IM, Yakum MN, Telefo PB. Prevalence and correlates of low serum calcium in late pregnancy: A cross sectional study in the Nkongsamba Regional Hospital; Littoral Region of Cameroon. PLoS One. 2019;14(11): e0224855. https://doi.org/10.1371/journal.pone.0224855.
10. Di Leo V, Capaccio F, Gesualdo L. Preeclampsia and glomerulonephritis: A bidirectional association. Curr Hypertens Rep. 2020;22(5):36. https://doi.org/10.1007/s11906-020-1033-9.
11. Vilallonga GD, de Almeida AG, Ribeiro KT, Campos SVA, Rodrigues AM. Hypothesized diprotomeric enzyme complex supported by stochastic modelling of palytoxin-induced Na/K pump channels. R Soc Open Sci. 2018;5(3):172155. https://doi.org/10.1098/rsos.172155.
12. Lindinger MI, Cairns SP. Regulation of muscle potassium: exercise performance, fatigue and health implications. Eur J Appl Physiol. 2021;121(3):721-748. https://doi.org/10.1007/s00421-020-04546-8.
13. Zhang L, Staehr C, Zeng F, Bouzinova EV, Matchkov VV. The Na, K-ATPase in vascular smooth muscle cells. Curr Top Membr. 2019; 83:151-175. https://doi.org/10.1016/bs.ctm.2019.01.007.
14. Li Y, Wu X, Mao Y, Liu C, Wu Y, Tang J, Zhao K, Li P. Nitric oxide alleviated high salt-induced cardiomyocyte apoptosis and autophagy independent of blood pressure in rats. Front Cell Dev Biol. 2021; 9:646575. https://doi.org/10.3389/fcell.2021.646575.
15. Frenkel A, Hassan L, Segal A, Israeli A, Binyamin Y, Zlotnik A, Novack V, Klein M. Estimation of potassium changes following potassium supplements in hypokalemic critically Ill adult patients-A patient personalized practical treatment formula. J Clin Med. 2021;10(9):1986. https://doi.org/10.3390/jcm10091986.
16. Coregliano-Ring L, Goia-Nishide K, Rangel ÉB. Hypokalemia in diabetes mellitus setting. Medicina (Kaunas). 2022;58(3):431. https://doi.org/10.3390/medicina58030431.
17. Kardalas E, Paschou SA, Anagnostis P, Muscogiuri G, Siasos G, Vryonidou A. Hypokalemia: a clinical update. Endocr Connect. 2018;7(4): R135-R146. https://doi.org/10.1530/EC-18-0109.
18. Sayyed A, Sonttake AN. Electrolyte Status in Preeclampsia. Online Int Interdiscip Res J. 2013;III(III):30-36.
19. Sidahmed M, Abubaker N, Elfadil G. Serum total calcium, magnesium, sodium and potassium in sudanese women with preeclampsia. Int J Adv Res. 2017;5(2):2061-2066. http://dx.doi.org/10.21474/IJAR01/3378.
20. Yussif M, Rahim S, Zbaar S, Marbut M. Estimation of serum zinc, sodium and potassium in normotensive and hypertensive primigravida pregnant women. Tikrit Medical Journal. 2009;15(1):13-18
21. Tominaga T, Ikeda K, Awazu M. Transient hypercalcemia followed by hypocalcemia in a preterm infant after maternal magnesium sulfate therapy. Clin Pediatr Endocrinol. 2022;31(2):77-80. http://dx.doi.org/10.1297/cpe.2021-0061.
22. Ziaei R, Askari G, Foshati S, Zolfaghari H, Clark CCT, Rouhani MH. Association between urinary potassium excretion and blood pressure: A systematic review and meta-analysis of observational studies. J Res Med Sci. 2020;25:116. http://dx.doi.org/10.4103/jrms.JRMS_167_20.
23. Wei KY, Gritter M, Vogt L, de Borst MH, Rotmans JI, Hoorn EJ. Dietary potassium and the kidney: lifesaving physiology. Clin Kidney J. 2020;13(6):952-968. http://dx.doi.org/10.1093/ckj/sfaa157.
24. Pickering RT, Bradlee ML, Singer MR, Moore LL. Higher Intakes of Potassium and Magnesium, but Not Lower Sodium, Reduce Cardiovascular Risk in the Framingham Offspring Study. Nutrients. 2021;13(1):269. http://dx.doi.org/10.3390/nu13010269.
25. Ngene NC, Daef G. Transient gestational hypertension and pre-eclampsia: Two case reports and literature review on the need for stringent monitoring. S Afr Fam Pract (2004). 2021;63(1): e1-e6. http://dx.doi.org/10.4102/safp.v63i1.5236.