Electrolytes variability and clinical outcomes, in-hospital mortality and acute kidney injury

Serum electrolytes are essential for basic life functioning. They play an important role in maintaining electrical neutrality in cells, generating and conducting action potentials in the nerves and muscles, cooperating to enzymatic functions. Electrolytes come from diet and serum concentrations are strictly regulated by the kidney, the main human organ deputed to control human hydro-electrolyte homeostasis. These electrolytes can have an imbalance, leading to either high or low levels. Disorders of sodium (Na+ ) and potassium (K+ ) are the most common electrolytes derangements observed in hospitalized population. High or low electrolytes levels disrupt normal bodily functions and can lead to even life-threatening complications. Medical literature has clearly demonstrated the association of Na+ and K+ disorders with poor prognosis of hospitalized patient. Recent scientific research reveals, however, that even little electrolyte changes might have a significant influence on patient survival. Furthermore, electrolytes fluctuations in a theoretical normal range should also warn medical attention. Given that the kidney is the primary organ engaged in electrolyte and water balance, the link between renal dysfunction and electrolyte abnormalities is unsurprising. Even though these disorders are generally considered to be a consequence of renal damage or simple bystanders, recent scientific evidence are now suggesting that electrolytes imbalance might precede kidney injury. The aim of my dissertation will focus on the studies conducted during the three years of my PhD program. Herein I am going to analyse the strong association between Na+ and K+ derangements and in-hospital clinical outcomes with particular attention on electrolytes variability or fluctuations even in the normal ranges and its relationship with in-hospital mortality and acute kidney injury.