A retrospective analysis of postoperative hypokalemia in pituitary adenomas after transsphenoidal surgery

Abstract

BackgroundPituitary adenoma is one of the most common intracranial neoplasms, and its primary treatment is endoscopic endonasal transsphenoidal tumorectomy. Postoperative hypokalemia in these patients is a common complication, and is associated with morbidity and mortality. This study aimed to analyze the etiopathology of postoperative hypokalemia in pituitary adenomas after endoscopic transsphenoidal surgery.Methods and MaterialsThis retrospective study included 181 pituitary adenomas confirmed by histopathology. Unconditional logistic regression analysis was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs). Repeated measures ANOVA was used to analyze change in serum potassium levels at different time points.ResultsMultiple Logistic regression analysis revealed that only ACTH-pituitary adenoma (OR = 4.92, 95% CI [1.18–20.48], P = 0.029) had a significant association with postoperative hypokalemia. Moreover, the overall mean serum potassium concentration was significantly lower in the ACTH versus the non-ACTH group (3.34 mmol/L vs. 3.79 mmol/L, P = 0.001). Postoperative hypokalemia was predominantly found in patients with ACTH-pituitary adenoma (P = 0.033).ConclusionsACTH-pituitary adenomas may be an independent factor related postoperative hypokalemia in patients despite conventional potassium supplementation in the immediate postoperative period.

Gender potentially affects early postoperative hyponatremia in pituitary adenoma: XGBoost-based predictive modeling

“…In contrast to conventional craniotomy surgery, transsphenoidal surgery is distinguished by reduced tissue damage, decreased operative duration, and expedited postoperative recuperation. While transsphenoidal surgery is considered a safer alternative, electrolyte imbalances, particularly hyponatremia and hypokalemia, are frequently encountered [ 24 , 25 ].…”

A Simple Scoring System for Predicting the Risk of Delayed Hyponatremia After Endoscopic Transsphenoidal Surgery for Pituitary Adenomas

“…Firstly, the use of glucocorticoids and mineralocorticoids during the operation can cause a decrease in blood potassium levels. Secondly, destruction of pituitary cells during surgery can release hormones, and the tumor tissue is squeezed out, leading to further hormone secretion [20]. The most common cause of delayed hyponatremia is syndrome of inappropriate antidiuretic hormone secretion (SIADH) [5], and early release of ADH may also cause hypokalaemia.…”

Development of a preoperative index-based nomogram for the prediction of hypokalemia in patients with pituitary adenoma: a retrospective cohort study

“…Moreover, recent evidence has demonstrated that this association was possibly due to age-related differences in body mass composition, which results in physiologically low total exchangeable body potassium in older patients (Kleinfeld et al, 1993). Many researchers have also concluded that the type of PA is associated with a difference in the prevalence of hypokalemia (Fan et al, 2020;You et al, 2017). You et al (2017) reported that, compared with other specific types of PA, patients with ACTH-PAs had a significantly higher prevalence of postoperative hypokalemia.…”

“…Many researchers have also concluded that the type of PA is associated with a difference in the prevalence of hypokalemia (Fan et al, 2020;You et al, 2017). You et al (2017) reported that, compared with other specific types of PA, patients with ACTH-PAs had a significantly higher prevalence of postoperative hypokalemia. ACTH-secreting PAs are related to a clinical disorder known as Cushing's disease (CD), and hypokalemia is a common feature in patients with CD.…”