Hipomagnesemia dengan atrial fluter pada pasien hemodialisis

• 發表在: JKS (Jurnal Kedokteran Syiah Kuala)
• 主要作者: Desi Salwani Hasan
• 格式: Article
• 語言: 英语
• 出版: Syiah Kuala University, Faculty of Medicine 2023-01-01
• 主題: magnesium, potassium, arrhytmia, hemodialysis
• 在線閱讀: https://jurnal.usk.ac.id/JKS/article/view/28662

Background: The incidence of arrhythmia in patients undergoing hemodialysis is about 41% with atrial fibrillation 9.8%. Low magnesium levels have a 50% higher risk of developing supraventricular arrhythmias. Electrolyte imbalance, fluid shift and myocardial ischemia due to hemodialysis can also trigger arrhythmias. Case illustration: Male patient aged 18 years with complaints of shortness of breath since 1 day before admission to the hospital. Pulse rate is 105 beats per minute, irregular, respiratory rate is 24 breaths per minute, temperature is 36.4°C, and oxygen saturation is 94%. Laboratory examination for potassium 3.20 mmol/L, calcium 8.3 mg/dL, creatinine 6.50 mg/dL and magnesium 1.0 mg/dL. From the electrocardiographic examination showed atrial flutter. During treatment, the patient received amiodarone, drip 600 mg MgSO4/day, potassium chloride tablet 600 mg two times a day, unfractioned heparin 5000 U/12 hours subcutaneously, hemodialysis 2 times a week. Discussion: Electrolyte imbalance during hemodialysis can also trigger arrhythmias. In this case there is hypomagnesemia and hypokalemia. Magnesium acts as a regulatory cation in cells, modulating calcium and potassium and other trans-membrane ions into cells. Magnesium affects the entry of potassium into cells through the ATP membrane. Correction of magnesium and potassium showed improvement in magnesium level and atrial flutter conditions. Conclusion: Changes in serum electrolyte levels, especially magnesium and potassium levels contribute to the incidence of arrhythmias in chronic kidney failure undergoing hemodialysis.