@article{10.11648/j.cmr.20221105.14,
  author = {Johannes Barg and Vitaliy Kazarcev and Alexey Astakhov},
  title = {Potassium in Red Blood Cells - A New Biomarker of Oxidative Stress by Sepsis},
  journal = {Clinical Medicine Research},
  volume = {11},
  number = {5},
  pages = {135-144},
  doi = {10.11648/j.cmr.20221105.14},
  url = {https://doi.org/10.11648/j.cmr.20221105.14},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.cmr.20221105.14},
  abstract = {There is increasing evidence that oxidants and antioxidants play a key role in the pathogenesis of sepsis. Sepsis is also characterized by excessive production of oxidants. Although many biomarkers for oxidative stress have been developed, the most biomarkers are technically very complex and they are not suitable for clinical routine. We discuss the possibility of using as a biomarker for oxidative stress by sepsis a new parameter - the concentration of potassium in red blood cells (RBC). The method for measuring potassium in erythrocytes, as well as the explanation for the increased potassium in the RBC, as a result of eryptosis (absorption of released potassium), was described by us earlier. Oxidative stress is known to be a major trigger for eryptosis - as a consequence, the increased potassium concentration in RBC directly reflects the intensity of oxidative stress. We also detect a tight buffer-like interaction between potassium in RBC and chlorine in plasma. Based on results from our study, we designed a nomogram for acid-base status of RBC. Method: In 66 patients (meeting criteria "Sepsis-3"), measurements of potassium in RBC were performed on the 1st, 3rd and 5th day stay at intensive care unit (ICU). The results: all patients had increased potassium in RBC on the 1st day. In the RBC nomogram, all measurements were in the range of metabolic acidosis. Over time, potassium in RBC normalized in surviving patients (n=42). In deceased patients (n=24), potassium in RBC fell with transition to metabolic alkalosis. A clear relationship was also noted between the concentration of potassium in the RBC and SOFA scale. The transition from metabolic acidosis to the metabolic alkalosis was accompanied by increased mortality. So, ROC - analysis showed high sensitivity and specificity of RBC acid-base status in predicting in-hospital mortality (AUROC = 0,78). Conclusion: The preliminary diagnostic model created on the basis of the nomogram allows assess the relationship of this parameter with the clinical course of sepsis. Basically, three approaches are conceivable for clinical practice: 1. Estimation of oxidative stress; 2. Estimation of RBC insufficiency or potassium deficiency; 3. Monitoring of antioxidant therapy. For the introduction into clinical routine, the automation of the method by Medical Industry is essential.},
 year = {2022}
}

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TY  - JOUR
T1  - Potassium in Red Blood Cells - A New Biomarker of Oxidative Stress by Sepsis
AU  - Johannes Barg
AU  - Vitaliy Kazarcev
AU  - Alexey Astakhov
Y1  - 2022/10/11
PY  - 2022
N1  - https://doi.org/10.11648/j.cmr.20221105.14
DO  - 10.11648/j.cmr.20221105.14
T2  - Clinical Medicine Research
JF  - Clinical Medicine Research
JO  - Clinical Medicine Research
SP  - 135
EP  - 144
PB  - Science Publishing Group
SN  - 2326-9057
UR  - https://doi.org/10.11648/j.cmr.20221105.14
AB  - There is increasing evidence that oxidants and antioxidants play a key role in the pathogenesis of sepsis. Sepsis is also characterized by excessive production of oxidants. Although many biomarkers for oxidative stress have been developed, the most biomarkers are technically very complex and they are not suitable for clinical routine. We discuss the possibility of using as a biomarker for oxidative stress by sepsis a new parameter - the concentration of potassium in red blood cells (RBC). The method for measuring potassium in erythrocytes, as well as the explanation for the increased potassium in the RBC, as a result of eryptosis (absorption of released potassium), was described by us earlier. Oxidative stress is known to be a major trigger for eryptosis - as a consequence, the increased potassium concentration in RBC directly reflects the intensity of oxidative stress. We also detect a tight buffer-like interaction between potassium in RBC and chlorine in plasma. Based on results from our study, we designed a nomogram for acid-base status of RBC. Method: In 66 patients (meeting criteria "Sepsis-3"), measurements of potassium in RBC were performed on the 1st, 3rd and 5th day stay at intensive care unit (ICU). The results: all patients had increased potassium in RBC on the 1st day. In the RBC nomogram, all measurements were in the range of metabolic acidosis. Over time, potassium in RBC normalized in surviving patients (n=42). In deceased patients (n=24), potassium in RBC fell with transition to metabolic alkalosis. A clear relationship was also noted between the concentration of potassium in the RBC and SOFA scale. The transition from metabolic acidosis to the metabolic alkalosis was accompanied by increased mortality. So, ROC - analysis showed high sensitivity and specificity of RBC acid-base status in predicting in-hospital mortality (AUROC = 0,78). Conclusion: The preliminary diagnostic model created on the basis of the nomogram allows assess the relationship of this parameter with the clinical course of sepsis. Basically, three approaches are conceivable for clinical practice: 1. Estimation of oxidative stress; 2. Estimation of RBC insufficiency or potassium deficiency; 3. Monitoring of antioxidant therapy. For the introduction into clinical routine, the automation of the method by Medical Industry is essential.
VL  - 11
IS  - 5
ER  - 

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