Hypophosphatemia in patients with acute stroke and diabetes mellitus: diagnosis and treatment

O.A. Halushko, M.V. Boliuk

Abstract


Background. Disorders of the water-electrolyte balance that arise in patients with acute stroke (AS) are one of the causes of its complicated course. At the same time, disorders of phosphate metabolism, especially hypophosphatemia (HPE), often remain beyond the attention of researchers. The purpose was to study the features of the course and results of treatment of HPE in patients with acute stroke on the background of diabetes mellitus (DM). Materials and methods. The study of phosphodiesterase disorders was performed in 346 patients with AS, who were divided into groups: 1) patients with AS on the background of DM (n = 104); 2) patients with AS without DM (n = 206); 3) control group (n = 36). HPE was corrected by the administration of D-fructose-1,6-diphosphate sodium (Esafosfina) in a dose of 1200–1500 mg/day. Results. Various types of electrolyte disturbances were observed in 256 out of 346 (73.98 %) patients with AS. HPE (phosphate level less than 0.8 mmol/l) was detected in 19 diabetic patients with AS (21.83 %) and 3 stroke patients without diabetes (4.68 %). Normalization of phosphate levels contributed to improving the patient’s condition and reducing the score on the National Institutes of Health Stroke Scale (from 12.8 to 7.0 in group 1 versus 12.9 to 10.1 in the control group, p < 0.05). Conclusions. Disturbances of phosphate exchange in diabetic patients with AS are significantly more frequent than in patients without diabetes (21.83 vs. 4.68 %, p < 0.01). Correction of severe HPE should be performed by intravenous administration of D-fructose-1,6-diphosphate sodium, which contributes to a significant reduction in neurological deficiency.


Keywords


stroke; electrolytes; phosphates; hypophosphatemia

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DOI: https://doi.org/10.22141/2224-0586.2.89.2018.126603

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