select ad.sno,ad.journal,ad.title,ad.author_names,ad.abstract,ad.abstractlink,j.j_name,vi.* from articles_data ad left join journals j on j.journal=ad.journal left join vol_issues vi on vi.issue_id_en=ad.issue_id where ad.sno_en='28885' and ad.lang_id='6' and j.lang_id='6' and vi.lang_id='6' Metabolic Abnormalities in Alcoholic Patients: Focus on Acid | 28885
アルコール依存症と薬物依存のジャーナル

アルコール依存症と薬物依存のジャーナル
オープンアクセス

ISSN: 2329-6488

概要

Metabolic Abnormalities in Alcoholic Patients: Focus on Acid Base and Electrolyte Disorders

Moses Elisaf MD and Rigas Kalaitzidis MD

Alcoholic patients commonly develop a variety of acid-base and electrolyte disturbances. The aim of this review is to describe the most commonly encountered abnormalities and their significant role in the patients’ morbidity and mortality. Physicians should be aware of these clinically important disturbances caused by alcohol abuse and their underlying pathophysiological mechanisms involved for their appropriate management.

Alcoholic Keto Acidosis (AKA) is a medical emergency is more common than previously thought and is characterized by an increased anion gap metabolic acidosis. However, in AKA mixed acid-base disorders are commonly observed. Alcoholic patients also exhibit severe electrolyte derangements. Multifactorial origin hypomagnesaemia is the most common electrolyte abnormality observed. Hypocalcaemia is also a frequent electrolyte disturbance and is commonly associated with hypomagnesaemia. Hypokalemia is occasionally encountered in these patients, while multifactorial origin hypophosphatemia is the second common electrolyte abnormality found. Hyponatremia is also a common electrolyte derangement and may occur subsequent to several mechanisms mediated by alcohol toxicity. Of special interest is the so-called beer potomania syndrome in poor nourished patients who consume a large amount of water with beer leading to hyponatremia. Chronic alcoholism and its comorbidities are a predisposing factor for the development of Central Pontine Myelinolisis during rapid correction of hyponatremia. Occasionally, alcoholic patients could be presented with alcohol-related intoxication mainly due to simultaneous methanol or ethylene glycol intoxication. In these cases the determination of the serum osmolal gap is used as a screening tool to identify potential toxins.

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