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https://www.readbyqxmd.com/read/27857927/a-fatal-adverse-effect-of-barbiturate-coma-therapy-dyskalemia
#1
Hyun Mook Kwon, Jin Wook Baek, Sang Pyung Lee, Jae Ik Cho
The management guideline for traumatic brain injury (TBI) recommends high-dose barbiturate therapy to control increased intracranial pressure refractory to other therapeutic options. High-dose barbiturate therapy, however, may cause many severe side effects; the commonly recognized ones include hypotension, immunosuppression, hepatic dysfunction, renal dysfunction, and prolonged decrease of cortical activity. Meanwhile, dyskalemia remains relatively uncommon. In this study, we report the case of a hypokalemic patient with severe rebound hyperkalemia, which occurred as a result of barbiturate coma therapy administered for TBI treatment...
October 2016: Korean Journal of Neurotrauma
https://www.readbyqxmd.com/read/27754188/sp-05-1-should-the-target-for-blood-pressure-reduction-be-lower-in-adults-with-hypertension-and-a-history-of-cardiovascular-disease
#2
Paul Whelton
BACKGROUND: Choice of the optimal target for blood pressure (BP) reduction during treatment of patients with hypertension, including those with underlying co-morbid conditions, is an important challenge in clinical practice. The Systolic Blood Pressure Intervention Trial (SPRINT) was designed to provide guidance in selection of a Systolic BP target during treatment of hypertension. METHODS: Adults ≥50 years old with hypertension and at least one additional risk factor for cardiovascular disease (CVD), but excluding persons with diabetes mellitus, prior stroke, or advanced chronic kidney disease (CKD) were randomly assigned to intensive therapy (intensive), targeting a systolic BP (SBP) <120 mmHg, or standard therapy (standard), targeting a SBP <140 mmHg...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27693804/emergency-management-of-severe-hyperkalemia-guideline-for-best-practice-and-opportunities-for-the-future
#3
Patrick Rossignol, Matthieu Legrand, Mikhail Kosiborod, Steven M Hollenberg, W Frank Peacock, Michael Emmett, Murray Epstein, Csaba P Kovesdy, Mehmet Birhan Yilmaz, Wendy Gattis Stough, Etienne Gayat, Bertram Pitt, Faiez Zannad, Alexandre Mebazaa
Hyperkalemia is a common electrolyte disorder, especially in chronic kidney disease, diabetes mellitus, or heart failure. Hyperkalemia can lead to potentially fatal cardiac dysrhythmias, and it is associated with increased mortality. Determining whether emergency therapy is warranted is largely based on subjective clinical judgment. The Investigator Network Initiative Cardiovascular and Renal Clinical Trialists (INI-CRCT) aimed to evaluate the current knowledge pertaining to the emergency treatment of hyperkalemia...
September 29, 2016: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
https://www.readbyqxmd.com/read/27502849/long-term-changes-of-renal-function-in-relation-to-ace-inhibitor-angiotensin-receptor-blocker-dosing-in-patients-with-heart-failure-and-chronic-kidney-disease
#4
Hanna Fröhlich, Christoph Nelges, Tobias Täger, Vedat Schwenger, Rita Cebola, Johannes Schnorbach, Kevin M Goode, Syed Kazmi, Hugo A Katus, John G F Cleland, Andrew L Clark, Lutz Frankenstein
BACKGROUND: Angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) have become cornerstones of therapy for chronic heart failure (CHF). Guidelines advise high target doses for ACEIs/ARBs, but fear of worsening renal function may limit dose titration in patients with concomitant chronic kidney disease (CKD). METHODS: In this retrospective observational study, we identified 722 consecutive patients with systolic CHF, stable CKD stage III/IV (estimated glomerular filtration rate [eGFR] 15-60 mL min(-1) 1...
August 2016: American Heart Journal
https://www.readbyqxmd.com/read/27269276/lisinopril-induced-alopecia-a-case-report
#5
Vivek Kataria, Hueyyoung Wang, Joyce W Wald, Yvonne L Phan
The American College of Cardiology Foundation/American Heart Association (ACCF/AHA) guidelines consider angiotensin-converting enzyme (ACE) inhibitors as one of the mainstay therapies in the management of heart failure. The widespread use of ACE inhibitors has been associated with several notable adverse effects such as hyperkalemia and an increased serum creatinine. There are no previous reports of alopecia associated with lisinopril use; however, a few previous cases of alopecia associated with other ACE inhibitors exist...
June 6, 2016: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/27254901/heart-failure-with-reduced-ejection-fraction-hyperkalemia-and-worsening-renal-function-as-challenges-to-implementation-guidelines-vs-real-world
#6
Patrick Rossignol
No abstract text is available yet for this article.
April 2016: Nephrology News & Issues
https://www.readbyqxmd.com/read/27207820/reduction-of-potassium-content-of-green-bean-pods-and-chard-by-culinary-processing-tools-for-chronic-kidney-disease
#7
Montserrat Martínez-Pineda, Cristina Yagüe-Ruiz, Alberto Caverni-Muñoz, Antonio Vercet-Tormo
INTRODUCTION: In order to prevent a possible hyperkalemia, chronic renal patients, especially in advanced stages, must follow a low potassium diet. So dietary guidelines for chronic kidney disease recommend limiting the consumption of many vegetables, as well as to apply laborious culinary techniques to maximize the reduction of potassium. OBJECTIVE: The aim of this work is to analyze potassium content from several vegetable, fresh products, frozen and preserved, as well as check and compare the effectiveness in potassium reduction of different culinary processes, some of them recommended in dietary guidelines such as soaking or double cooking...
July 2016: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
https://www.readbyqxmd.com/read/27181293/renal-replacement-therapy-in-the-critically-ill-does-timing-matter
#8
EDITORIAL
Ravindra L Mehta
No abstract text is available yet for this article.
July 14, 2016: New England Journal of Medicine
https://www.readbyqxmd.com/read/27180623/recent-advances-in-pharmacological-treatments-of-hyperkalemia-focus-on-patiromer
#9
Murray Epstein, Bertram Pitt
INTRODUCTION: Hyperkalemia is a common electrolyte disorder, especially among patients with chronic kidney disease (CKD), diabetes mellitus, or heart failure, and is associated with a significantly increased risk for all-cause mortality. Hyperkalemia remains a vexing and challenging problem for clinicians, particularly in the management of patients with chronic kidney disease and congestive heart failure. Several observational and retrospective studies have reported a large gap between recommendations in guidelines and real-world practice in the implementation of RAASi therapies...
July 2016: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/27118291/hypertension-canada-s-2016-canadian-hypertension-education-program-guidelines-for-blood-pressure-measurement-diagnosis-assessment-of-risk-prevention-and-treatment-of-hypertension
#10
Alexander A Leung, Kara Nerenberg, Stella S Daskalopoulou, Kerry McBrien, Kelly B Zarnke, Kaberi Dasgupta, Lyne Cloutier, Mark Gelfer, Maxime Lamarre-Cliche, Alain Milot, Peter Bolli, Guy Tremblay, Donna McLean, Sheldon W Tobe, Marcel Ruzicka, Kevin D Burns, Michel Vallée, G V Ramesh Prasad, Marcel Lebel, Ross D Feldman, Peter Selby, Andrew Pipe, Ernesto L Schiffrin, Philip A McFarlane, Paul Oh, Robert A Hegele, Milan Khara, Thomas W Wilson, S Brian Penner, Ellen Burgess, Robert J Herman, Simon L Bacon, Simon W Rabkin, Richard E Gilbert, Tavis S Campbell, Steven Grover, George Honos, Patrice Lindsay, Michael D Hill, Shelagh B Coutts, Gord Gubitz, Norman R C Campbell, Gordon W Moe, Jonathan G Howlett, Jean-Martin Boulanger, Ally Prebtani, Pierre Larochelle, Lawrence A Leiter, Charlotte Jones, Richard I Ogilvie, Vincent Woo, Janusz Kaczorowski, Luc Trudeau, Robert J Petrella, Swapnil Hiremath, Denis Drouin, Kim L Lavoie, Pavel Hamet, George Fodor, Jean C Grégoire, Richard Lewanczuk, George K Dresser, Mukul Sharma, Debra Reid, Scott A Lear, Gregory Moullec, Milan Gupta, Laura A Magee, Alexander G Logan, Kevin C Harris, Janis Dionne, Anne Fournier, Geneviève Benoit, Janusz Feber, Luc Poirier, Raj S Padwal, Doreen M Rabi
Hypertension Canada's Canadian Hypertension Education Program Guidelines Task Force provides annually updated, evidence-based recommendations to guide the diagnosis, assessment, prevention, and treatment of hypertension. This year, we present 4 new recommendations, as well as revisions to 2 previous recommendations. In the diagnosis and assessment of hypertension, automated office blood pressure, taken without patient-health provider interaction, is now recommended as the preferred method of measuring in-office blood pressure...
May 2016: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/26958701/the-safety-of-mineralocorticoid-receptor-antagonists-mras-in-patients-with-heart-failure
#11
Bertram Pitt, Patrick Rossignol
INTRODUCTION: Mineralocorticoid receptor antagonists (MRAs) have been accorded a class 1 indication for patients with chronic heart failure and a reduced left ventricular ejection fraction (HFREF) in both European and American guidelines. Uptake, however, has been less than optimal largely due to concerns about their safety, in particular the risk of hyperkalemia and renal dysfunction. AREAS COVERED: This review presents the current state of affairs regarding the safety of MRAs in heart failure with reduced ejection fraction...
May 2016: Expert Opinion on Drug Safety
https://www.readbyqxmd.com/read/26891235/impact-of-aldosterone-antagonists-on-sudden-cardiac-death-prevention-in-heart-failure-and-post-myocardial-infarction-patients-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#12
REVIEW
Hai-Ha Le, Chadia El-Khatib, Margaux Mombled, Frédéric Guitarian, Muaamar Al-Gobari, Mor Fall, Perrine Janiaud, Ivanny Marchant, Michel Cucherat, Théodora Bejan-Angoulvant, François Gueyffier
BACKGROUND AND OBJECTIVES: Sudden cardiac death (SCD) is a severe burden of modern medicine. Aldosterone antagonist is publicized as effective in reducing mortality in patients with heart failure (HF) or post myocardial infarction (MI). Our study aimed to assess the efficacy of AAs on mortality including SCD, hospitalization admission and several common adverse effects. METHODS: We searched Embase, PubMed, Web of Science, Cochrane library and clinicaltrial.gov for randomized controlled trials (RCTs) assigning AAs in patients with HF or post MI through May 2015...
2016: PloS One
https://www.readbyqxmd.com/read/26879307/has-raas-blockade-reached-its-limits-in-the-treatment-of-diabetic-nephropathy
#13
REVIEW
Collen Majewski, George L Bakris
Medications that block the renin-angiotensin-aldosterone system (RAAS) are a cornerstone of diabetic nephropathy treatment. These agents play an important role in slowing the nephropathy progression in patients with diabetes. Clinical outcome trials that investigated use of these drug classes in patients with diabetic nephropathy have demonstrated clinical significant benefit in slowing nephropathy progression only in people with >300 mg/day of proteinuria. Thus, guidelines mandate their use in such patients...
April 2016: Current Diabetes Reports
https://www.readbyqxmd.com/read/26796254/effectiveness-and-safety-of-aldosterone-antagonist-therapy-use-among-older-patients-with-reduced-ejection-fraction-after-acute-myocardial-infarction
#14
Tracy Y Wang, Amit N Vora, S Andrew Peng, Gregg C Fonarow, Sandeep Das, James A de Lemos, Eric D Peterson
BACKGROUND: While aldosterone antagonists have proven benefit among post-myocardial infarction (MI) patients with low ejection fraction (EF), how this treatment is used among older MI patients in routine practice is not well described. METHODS AND RESULTS: Using ACTION Registry-GWTG linked to Medicare data, we examined 12 080 MI patients ≥65 years with EF ≤40% who were indicated for aldosterone antagonist therapy per current guidelines and without documented contraindications...
January 2016: Journal of the American Heart Association
https://www.readbyqxmd.com/read/26788745/the-burden-of-hyperkalemia-in-patients-with-cardiovascular-and-renal-disease
#15
Jeffrey D Dunn, Wade W Benton, Ernesto Orozco-Torrentera, Robert T Adamson
Hyperkalemia is a potentially serious condition that can result in life-threatening cardiac arrhythmias and is associated with an increased mortality risk. Patients older than 65 years who have an advanced stage of chronic kidney disease (stage 3 or higher), diabetes, and/or chronic heart failure are at higher risk for hyperkalemia. To reduce disease progression and improve outcomes in these groups of patients, modulation of the renin-angiotensin-aldosterone system (RAAS) is recommended by guidelines. One limiting factor of RAAS inhibitors at proven doses is the increased risk for hyperkalemia associated with their use...
November 2015: American Journal of Managed Care
https://www.readbyqxmd.com/read/26781039/knowledge-of-physicians-on-chronic-kidney-disease-and-their-attitudes-towards-referral-in-two-cities-of-cameroon-a-cross-sectional-study
#16
Simeon-Pierre Choukem, Pennghan K Nchifor, Marie-Patrice Halle, Daniel N Nebongo, Yannick Mboue-Djieka, François F Kaze, Gotlieb L Monekosso
BACKGROUND: Chronic kidney disease (CKD) is frequently unrecognized by non-nephrology physicians. There is an ongoing governmental program to create hemodialysis centers in the ten regions of Cameroon, where a previous study reported high levels of late referral to nephrologists. We aimed to assess the knowledge of physicians on CKD and their attitudes regarding referral. METHODS: A questionnaire based on the Kidney Disease Outcome Quality Initiative Guidelines of 2002 was self-administered to general practitioners and non-nephrology specialists working in two Cameroon cities that have hemodialysis centers (Douala and Bamenda)...
January 18, 2016: BMC Research Notes
https://www.readbyqxmd.com/read/26779423/comparison-of-estimated-glomerular-filtration-rate-equations-at-the-time-of-hemodialysis-initiation
#17
Min-Jeong Lee, Seirhan Kim, Inwhee Park, Heungsoo Kim, Gyu-Tae Shin
BACKGROUND: Estimated glomerular filtration rate (eGFR) is one of the most important guidelines in deciding the optimal timing of dialysis initiation. In the present study, we calculated the eGFR at the time of hemodialysis (HD) initiation using 5 commonly used equations to relate them with clinical and laboratory characteristics of the patients and to evaluate which of these equations best define the eGFR at HD initiation. METHODS: We retrospectively analyzed 409 end-stage renal disease patients who were newly started on HD treatment in our institution...
December 2015: Kidney Research and Clinical Practice
https://www.readbyqxmd.com/read/26766168/management-of-hypertension-in-diabetic-nephropathy-how-low-should-we-go
#18
Hillel Sternlicht, George L Bakris
Hypertension is a frequent comorbidity often following the development of diabetic nephropathy among individuals with type 1 diabetes and affecting most patients with type 2 diabetes at the time of diagnosis. Multiple prospective randomized placebo-controlled trials demonstrate that tight blood pressure control among patients with diabetic nephropathy reduces the rates of macrovascular and microvascular complications. While randomized trials exist and support a blood pressure goal of <140/90 mm Hg for patients with nondiabetic kidney disease, there are no prospective data regarding a specific blood pressure goal on progression of diabetic nephropathy...
2016: Blood Purification
https://www.readbyqxmd.com/read/26701834/na-k-cl-acid-base-or-h2o-homeostasis-in-children-with-urinary-tract-infections-a-narrative-review
#19
REVIEW
Anna Bertini, Gregorio P Milani, Giacomo D Simonetti, Emilio F Fossali, Pietro B Faré, Mario G Bianchetti, Sebastiano A G Lava
Guidelines on the diagnosis and management of urinary tract infections in childhood do not address the issue of abnormalities in Na(+), K(+), Cl(-) and acid-base balance. We have conducted a narrative review of the literature with the aim to describe the underlying mechanisms of these abnormalities and to suggest therapeutic maneuvers. Abnormalities in Na(+), K(+), Cl(-) and acid-base balance are common in newborns and infants and uncommon in children of more than 3 years of age. Such abnormalities may result from factitious laboratory results, from signs and symptoms (such as excessive sweating, poor fluid intake, vomiting and passage of loose stools) of the infection itself, from a renal dysfunction, from improper parenteral fluid management or from the prescribed antimicrobials...
September 2016: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/26687571/incidence-of-and-risk-factors-for-severe-acute-kidney-injury-in-children-with-heart-failure-treated-with-renin-angiotensin-system-inhibitors
#20
Chikako Terano, Kenji Ishikura, Masaru Miura, Riku Hamada, Ryoko Harada, Tomoyuki Sakai, Yuko Hamasaki, Hiroshi Hataya, Takashi Ando, Masataka Honda
UNLABELLED: No large cohort study has yet determined the incidence of acute kidney injury (AKI) in children with heart failure treated with renin-angiotensin system (RAS) inhibitors. We thus retrospectively analyzed the incidence and risk factors for severe AKI (stages 2-3 according to the Kidney Disease Improving Global Outcomes (KDIGO) guidelines) at our institutions from 2008 to 2011. Among 312 children (162 boys; median age, 7.3 months), 59 cases of AKI occurred in 45 children. The incidence of AKI was 14...
May 2016: European Journal of Pediatrics
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