Electrolytes and Nutritional Element Assessment among Iraqi Cancer Patients Receiving Chemotherapy
DOI:
https://doi.org/10.3889/oamjms.2021.5426Keywords:
Cancer, Electrolytes, Nutritional element, Iraqi patients, ChemotherapyAbstract
INTRODUCTION: Cancer may lead to abnormalities in electrolyte levels and acid-base disturbances in affected patients that could be induced by the tumor itself or by chemotherapy treatment. Thus, early detection is vital to improve short-term outcome and quality of life.
AIM: This study aims to assess the electrolyte and protein changes in cancer patients on chemotherapy.
MATERIALS AND METHODS: A cohort study was carried out on 100 newly diagnosed patients with cancer in Al-Amal National Radiation Oncology Hospital in Baghdad, Iraq, during the period from January 2019 to July 2019. An assessment of the studied samples was conducted as a baseline measure before receiving chemotherapy and after the third cycle of that treatment. Quantitative parameters included measurements of serum magnesium, calcium, sodium, chloride, potassium, zinc, Hb1Ac, total protein, and ferritin. Data analysis was carried out using Student’s t-test for variable levels. Level of significance of ≤0.05 was considered as significant.
RESULTS: The studied sample comprised 77 females (77%) and 23 males (23%). There were significant decreases in the levels of magnesium and zinc while no significant changes were noted in the levels of other electrolytes. On the other hand, there was a significant decrease in the level of proteins and a significant rise in HBA1c and ferritin.
CONCLUSION: Cancer patients on chemotherapy regimens suffer from major changes in the levels of vitamins, elements, and neurotransmitter that affect their lifestyle, survival, and prognosis. Frequent regular monitoring of such changes is required to harvest a positive impact on the lifestyle of cancer patients lifestyle and their outcome.Downloads
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World Health Organization. Global Health Observatory. Geneva: World Health Organization; 2018. Available from: https://www.who.int/gho/database/en. [Last accesssed on 2018 Jun 21].
Rosner MH, Capasso G, Perazella MA. Acute kidney injury and electrolyte disorders in the critically ill patient with cancer. Curr Opin Crit Care. 2017;23(6):475-83. https://doi.org/10.1097/mcc.0000000000000450 PMid:28953555
Boscoe A, Paramore C, Verbalis JG. Cost of illness of hyponatremia in the United States. Cost Eff Resour Alloc. 2006;4(1):10. https://doi.org/10.1186/1478-7547-4-10 PMid:16737547
Yang Y, Sun N, Sun P, Zhang L. Clinical characteristics and prognosis of elderly small cell lung cancer patients complicated with hyponatremia: A retrospective analysis. Anticancer Res. 2017;37(8):4681-6. https://doi.org/10.21873/anticanres.11872 PMid:28739771
Mohammed DS, Daoud FA. Assessment of dietary intake in patients with breast cancer receiving chemotherapy. Int J Sci Res. 2015;4(11):1520-5.
Merza W, Majid A, Daoud M, Almothaffar A. Serum magnesium concentration in patients with leukemia and lymphoma. J Fac Med Baghdad. 2008;52:101-4.
Karasawa T, Steyger PS. An integrated view of cisplatin-induced nephrotoxicity and ototoxicity. Toxicol Lett. 2015;237(3):219-27. https://doi.org/10.1016/j.toxlet.2015.06.012 PMid:26101797
Carroll B, Fleisher M, Pessin MS, Richardson S, Ramanathan LV. Pseudohypocalcemia in cancer patients: A recommendation for the postanalytical correction of serum calcium in patients with hypoalbuminemia. Clin Chem. 2017;63(7):1302-4. https://doi.org/10.1373/clinchem.2017.272997 PMid:28515104
Abu-Alfa AK, Younes A. Tumor lysis syndrome and acute kidney injury: Evaluation, prevention, and management. Am J Kidney Dis. 2010;55 Suppl 5:S1-3; quiz S14-9. https://doi.org/10.1053/j.ajkd.2009.10.056 PMid:20420966
Joshita S, Yoshizawa K, Sano K, Kobayashi S, Sekiguchi T, Morita S, et al. A patient with advanced hepatocellular carcinoma treated with sorafenib tosylate showed massive tumor lysis with avoidance of tumor lysis syndrome. Intern Med. 2010;49(11):991-4. https://doi.org/10.2169/internalmedicine.49.3153 PMid:20519814
Askar AM. Hyperphosphatemia. The hidden killer in chronic kidney disease. Saudi Med J. 2015;36(1):13-9. https://doi.org/10.15537/smj.2015.1.9843 PMid:25629999
Castillo JJ, Vincent M, Justice E. Diagnosis and management of hyponatremia in cancer patients. Oncologist. 2012;17(6):756-65. PMid:22618570
Siddiqui A, Kumari R, Zia M, Zubair T, Imtiaz S, Sahar N, et al. Correlation of duration of chemotherapy with electrolytes in cancer patients: A prospective study assessing the relationship with various electrolytes. Symbiosis. 2018;5:1-4.
Solomon R. The relationship between disorders of K+ and Mg+ homeostasis. Semin Nephrol. 1987;7(3):253-62. PMid:3317639
Da-Costa-Rocha I, Bonnlaender B, Sievers H, Pischel I, Heinrich M. Hibiscus sabdariffa L. -A phytochemical and pharmacological review. Food Chem. 2014;165:424-43. https://doi.org/10.1016/j.foodchem.2014.05.002 PMid:25038696
Wang Y, Sun Z, Li A, Zhang Y. Association between serum zinc levels and lung cancer: A meta-analysis of observational studies. World J Surg Oncol. 2019;17(1):78. https://doi.org/10.1186/s12957-019-1617-5 PMid:31060563
Shivappa N, Steck SE, Hurley TG, Hussey JR, Hébert JR. Designing and developing a literature-derived, population-based dietary inflammatory index. Public Health Nutr. 2013;17(8):1689- 96. https://doi.org/10.1017/s1368980013002115 PMid:23941862
Schwartz MK. Role of trace elements in cancer. Cancer Res. 1975;35(11):3481-7. PMid:1104155
Melichar B, Malir F, Jandik P, Malirova E, Vavrova J, Mergancova J, et al. Increased urinary zinc excretion in cancer patients is linked to immune activation and renal tubular cell dysfunction. Biometals. 1995;8(3):205-8. https://doi.org/10.1007/bf00143377 PMid:7647517
Soeters PB, Wolfe RR, Shenkin A. Hypoalbuminemia: Pathogenesis and clinical significance. JPEN J Parenter Enteral Nutr. 2019;43(2):181-93. https://doi.org/10.1002/jpen.1451 PMid:30288759
Yokota T, Ando N, Igaki H, Shinoda M, Kato K, Mizusawa J, et al. Prognostic factors in patients receiving neoadjuvant 5-fluorouracil plus cisplatin for advanced esophageal cancer (JCOG9907). Oncology. 2015;89(3):143-51. https://doi.org/10.1159/000381065 PMid:25895447
Hershey DS, Hession S. Chemotherapy and glycemic control in patients with Type 2 diabetes and cancer: A comparative case analysis. Asia Pac J Oncol Nurs. 2017;4(3):224-32. https://doi.org/10.4103/apjon.apjon_22_17 PMid:28695169
Alkhateeb AA, Connor JR. The significance of ferritin in cancer: Anti-oxidation, inflammation and tumorigenesis. Biochim Biophys Acta. 2013;1836(2):245-54. PMid:23891969
Nocka KH, Pelus LM. Cell cycle specific effects of deferoxamine on human and murine hematopoietic progenitor cells. Cancer Res. 1988;48(13):3571-5. PMid:3378203
Kennedy TP, Rao NV, Noah W, Michael JR, Jafri MH Jr., Gurtner GH, et al. Ibuprofen prevents oxidant lung injury and in vitro lipid peroxidation by chelating iron. J Clin Invest. 1990;86(5):1565-73. https://doi.org/10.1172/jci114876 PMid:2173723
Beguin Y. Prediction of response and other improvements on the limitations of recombinant human erythropoietin therapy in anemic cancer patients. Haematologica. 2002;87(11):1209-21. PMid:12414352
Song A, Eo W, Kim S, Shim B, Lee S. Significance of serum ferritin as a prognostic factor in advanced hepatobiliary cancer patients treated with Korean medicine: A retrospective cohort study. BMC Complement Altern Med. 2018;18(1):176. https://doi.org/10.1186/s12906-018-2240-7 PMid:29879960
Nemeth E, Rivera S, Gabayan V, Keller C, Taudorf S, Pedersen BK, et al. IL-6 mediates hypoferremia of inflammation by inducing the synthesis of the iron regulatory hormone hepcidin. J Clin Invest. 2004;113(9):1271-6. https://doi.org/10.1172/jci200420945 PMid:15124018
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Copyright (c) 2021 Mohammed Salim Abdulrahman , Hedef D. El-Yassin, Nada A. S. Alwan (Author)
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