The Association Between Chronic Hypokalemia and Advanced Stages of High-Volume Solid Tumors

Export Objective: Hypokalemia can be caused by an acute increase in hematopoietic cell production, which leads to the uptake of potassium by these new cells (e.g., after vitamin B12, folic acid, and granulocyte-macrophage colony-stimulating factor, and in patients with acute myeloid leukemia and a high white blood cell count). Hypokalemia is a common multifactorial electrolyte abnormality in cancer patients. We hypothesize that a large tumor burden related to advanced solid tumors could potentially contribute to a redistribution of potassium, resulting in the development of hypokalemia. The objective of this study was to examine the hypothesis mentioned above, which, to the best of our knowledge, had been reported sparsely in the literature. Methods: A prospective pilot study was conducted from January 2011 to December 2011. All newly diagnosed, treatment naïve solid tumor patients in Northwest Armed Forces Hospital (Tabuk, Saudi Arabia) who met the study criteria were included and studied. Serum potassium measurements were carried out, and staging was categorized into stages I, II, III, and IV, according to the American Joint Committee on Cancer (7th edition 2010). All patients who have hypokalemia underwent an extensive workup to rule out other causes of hypokalemia. Kai square analysis was used to determine the association. Results: A total of 152 patients were included in the study, consisting of 84 females and 68 males. Clinical stages I, II, III, and IV were 6%, 17%, 27%, and 50%, respectively. Chronic hypokalemia was found in 15 (9.8%) patients. Out of them, 13 patients had stage IV, whereas only one patient had stage III and stage II disease. These findings suggest a notable correlation between hypokalemia and advanced stages of large-burden solid tumors (P-value=0.028). Conclusions: Chronic hypokalemia could be a marker for the advanced stage of high-burden solid cancers. The clinical utility of this marker requires further confirmation through additional trials. Its utility as a biochemical marker to define the poor prognosis, progression, and recurrence should be assessed.