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Hyperkalemia

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https://www.readbyqxmd.com/read/28528336/racial-and-ethnic-differences-in-mortality-associated-with-serum-potassium-in-a-large-hemodialysis-cohort
#1
Taehee Kim, Connie M Rhee, Elani Streja, Melissa Soohoo, Yoshitsugu Obi, Jason A Chou, Amanda R Tortorici, Vanessa A Ravel, Csaba P Kovesdy, Kamyar Kalantar-Zadeh
BACKGROUND: Hyperkalemia is observed in chronic kidney disease patients and may be a risk factor for life-threatening arrhythmias and death. Race/ethnicity may be important modifiers of the potassium-mortality relationship in maintenance hemodialysis (MHD) patients given that potassium intake and excretion vary among minorities. METHODS: We examined racial/ethnic differences in baseline serum potassium levels and all-cause and cardiovascular mortality using Cox proportional hazard models and restricted cubic splines in a cohort of 102,241 incident MHD patients...
May 20, 2017: American Journal of Nephrology
https://www.readbyqxmd.com/read/28516402/effects-of-calcineurin-inhibitors-on-sodium-excretion-in-recipients-of-allogeneic-hematopoietic-stem-cell-transplantation
#2
Masuho Saburi, Sumiko Kohashi, Jun Kato, Yuya Koda, Masatoshi Sakurai, Takaaki Toyama, Taku Kikuchi, Daiki Karigane, Sayako Yuda, Yusuke Yamane, Risa Hashida, Ryohei Abe, Tomonori Nakazato, Junichi Hirahashi, Masao Ogata, Shinichiro Okamoto, Takehiko Mori
Calcineurin inhibitors (CIs) such as cyclosporine A (CSA) and tacrolimus often cause renal dysfunction, resulting in increased serum creatinine, hyperkalemia, and hyperuricemia. However, the effects of CIs on sodium excretion have not been fully elucidated. We retrospectively evaluated the effects of CI administration on sodium excretion in recipients of allogeneic hematopoietic stem cell transplantation (HSCT). Fifty consecutive recipients each of allogeneic HSCT receiving either CSA or tacrolimus (100 patients in total) with available data for weekly fractional excretion of sodium (FENa) for a 4-week period after transplantation were enrolled in this retrospective analysis...
May 17, 2017: International Journal of Hematology
https://www.readbyqxmd.com/read/28515827/transient-left-bundle-branch-block-due-to-severe-hyperkalemia
#3
Kishore Kumar, Madhavi Biyyam, Amandeep Singh, Bharat Bajantri, Hassan Tariq, Suresh Kumar Nayudu, Sridhar Chilimuri
Hyperkalemia is a potentially life-threatening electrolyte imbalance that can lead to sudden death from cardiac arrhythmias and asystole. We present a case of transient left bundle branch block pattern on an electrocardiogram (ECG) secondary to hyperkalemia in a patient with history of end-stage renal disease. A 52-year-old man presented to the emergency room (ER) with chief complaints of weakness and lethargy after missing his regularly scheduled session of hemodialysis. A 12-lead ECG in the ER showed sinus tachycardia at 118 beats/min, wide QRS complexes, peaked T waves and left bundle branch block-like pattern...
April 2017: Cardiology Research
https://www.readbyqxmd.com/read/28511177/familial-hyperkalemia-and-hypertension-fhht-and-klhl3-description-of-a-family-with-a-new-recessive-mutation-s553l-compared-to-a-family-with-a-dominant-mutation-q309r-with-analysis-of-urinary-sodium-chloride-cotransporter
#4
Orit Kliuk-Ben Bassat, Vered Carmon, Aaron Hanukoglu, Liat Ganon, Eias Massalha, Eliezer J Holtzman, Zvi Farfel, Haim Mayan
BACKGROUND: Familial hyperkalemia and hypertension (FHHt) is an inherited disorder manifested by hyperkalemia and hypertension. The following four causative genes were identified: WNK1, WNK4, CUL3, and KLHL3. For the first 3 genes, inheritance is autosomal dominant. For KLHL3, inheritance is mostly dominant. A few cases with autosomal recessive disease were described. The mechanism of these 2 modes of inheritance is not clear. In the recessive form, the phenotype of heterozygotes is not well described...
May 17, 2017: Nephron
https://www.readbyqxmd.com/read/28505194/comparative-effectiveness-of-angiotensin-converting-enzyme-inhibitors-versus-angiotensin-ii-receptor-blockers-for-major-renal-outcomes-in-patients-with-diabetes-a-15-year-cohort-study
#5
Hon-Yen Wu, Chiao-Ling Peng, Pei-Chun Chen, Chih-Kang Chiang, Chee-Jen Chang, Jenq-Wen Huang, Yu-Sen Peng, Yu-Kang Tu, Tzong-Shinn Chu, Kuan-Yu Hung, Kuo-Liong Chien
BACKGROUND: Angiotensin converting enzyme inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs) are considered to have similar renoprotective effects; so far there has been no consensus about their priorities. This study aimed to compare ACEIs and ARBs for major renal outcomes and survival in a 15-year cohort of adults with diabetes. METHODS: This study utilized Taiwan's medical and pharmacy claims data in the Longitudinal Cohort of Diabetes Patients. The primary outcome was long-term dialysis, and secondary outcomes were hospitalization for acute kidney injury, hospitalization for hyperkalemia, all-cause death, cardiovascular death, and non-cardiovascular death...
2017: PloS One
https://www.readbyqxmd.com/read/28505191/lp25-membrane-protein-from-pathogenic-leptospira-spp-is-associated-with-rhabdomyolysis-and-oliguric-acute-kidney-injury-in-a-guinea-pig-model-of-leptospirosis
#6
Patrícia A E Abreu, Antonio C Seguro, Daniele Canale, Ana Maria G da Silva, Larissa do R B Matos, Tatiane B Gotti, Denize Monaris, Denise A de Jesus, Sílvio A Vasconcellos, Thales de Brito, Antonio J B Magaldi
Acute kidney injury (AKI) from leptospirosis is frequently nonoliguric with hypo- or normokalemia. Higher serum potassium levels are observed in non-survivor patients and may have been caused by more severe AKI, metabolic disarrangement, or rhabdomyolysis. An association between the creatine phosphokinase (CPK) level and maximum serum creatinine level has been observed in these patients, which suggests that rhabdomyolysis contributes to severe AKI and hyperkalemia. LipL32 and Lp25 are conserved proteins in pathogenic strains of Leptospira spp...
May 15, 2017: PLoS Neglected Tropical Diseases
https://www.readbyqxmd.com/read/28497085/evaluation-of-water-and-electrolytes-disorders-in-severe-acute-diarrhea-patients-treated-by-who-protocol-in-eight-large-hospitals-in-tehran-a-nephrology-viewpoint
#7
Alireza Soleimani, Fatemeh Foroozanfard, Mohammad Reza Tamadon
Introduction: The most common cause of death from diarrhea is the shock caused by dehydration, electrolytes and acid-base disorders. Objectives: The aim of this study was to evaluate water and electrolytes disorders in diarrhea patients after treating severe acute diarrhea. Patients and Methods: In this study we used a historical cohort and studied patients who were hospitalized due to acute diarrhea and were similarly treated for dehydration and water and electrolyte disorders as recommended by the World Health Organization (WHO) guideline...
2017: Journal of Renal Injury Prevention
https://www.readbyqxmd.com/read/28487869/a-curious-case-of-persistently-relapsing-hyperkalemia-in-an-esrd-patient-on-maintenance-hemodialysis-following-bioprosthetic-aortic-valve-replacement-a-potential-case-for-the-use-of-the-new-agent-patiromer-for-hyperkalemia-management
#8
Macaulay Amechi Chukwukadibia Onuigbo, Nneoma Agbasi, Fidelis Oguejiofor, Charles Odenigbo
Hyperkalemia is not uncommon in patients with end-stage renal disease (ESRD) on maintenance hemodialysis, often related to dietary indiscretion, following the prolonged inter-dialytic weekend interval in patients on thrice weekly hemodialysis treatments, and sometimes the adverse effects of medications such as RAAS blocking agents. Moreover, hyperkalemia following extended cardiac surgery can result from the use of high-potassium containing cardioplegic solutions used during cardiopulmonary bypass. Nevertheless, different from the foregoing, in the nephrology literature, there have been very rare reports of potentially life-threatening hyperkalemia following cardiac valve replacement procedure...
2017: Journal of Renal Injury Prevention
https://www.readbyqxmd.com/read/28487284/implementation-of-a-timed-electronic-assessment-driven-potassium-replacement-protocol
#9
Christopher Zielenski, Adam Crabtree, Tien Le, Alyse Marlatt, Dana Ng, Alan Tran
PURPOSE: The adherence to and effectiveness and safety of a timed, electronic, assessment-driven potassium-replacement protocol (TARP) were compared with an electronic nurse-driven replacement protocol (NRP) are reported. METHODS: A retrospective observational study was conducted in a community hospital evaluating protocol adherence, effectiveness, and safety for 2 potassium-replacement protocols. All adults on medical units with an order for potassium replacement per protocol during the 3-month trial periods were reviewed...
May 9, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28485203/expert-panel-recommendations-for-the-identification-and-management-of-hyperkalemia-and-role-of-patiromer-in-patients-with-chronic-kidney-disease-and-heart-failure
#10
Zubaid Rafique, Matthew R Weir, Macaulay Onuigbo, Bertram Pitt, Richard Lafayette, Javed Butler, Maria Lopes, Carolyn Farnum, W Frank Peacock
Virtual panel meetings were conducted among 7 physicians, all of whom are independent experts, including 3 nephrologists, 2 cardiologists, and 2 emergency medicine physicians (the panel). The panel met with the purpose of discussing the current treatment landscape, treatment challenges, economic impact, and gaps in care for patients with hyperkalemia that is associated with heart failure and chronic kidney disease. The stated goal of the panel discussion was to develop practical solutions in the identification and management of hyperkalemia in this patient population...
April 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28485202/clinical-and-economic-impact-of-hyperkalemia-in-patients-with-chronic-kidney-disease-and-heart-failure
#11
Michael Polson, Todd C Lord, Anne Kangethe, Lindsay Speicher, Carolyn Farnum, Melanie Brenner, Nina Oestreicher, Paula Alvarez
BACKGROUND: Hyperkalemia (HK) is a concern for patients with chronic kidney disease (CKD) and heart failure (HF), and for those receiving treatments that inhibit the renin-angiotensin-aldosterone system (RAASi). An analysis of 1.7 million medical records of patients in the United States revealed that among individuals with more than 2 potassium values during 2007 to 2012, HK was detected in 34.6% of patients with CKD and 30.0% of patients with HF. OBJECTIVE: To evaluate the association of HK and use of RAASi therapies at optimal and suboptimal doses in patients with CKD and/or HF with health care resource utilization and overall cost of care in a diverse cohort of commercially insured patients...
April 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28484659/systemic-pseudohypoaldosteronism-type-i-a-case-report-and-review-of-the-literature
#12
Nasifa Nur, Cameron Lang, Juanita K Hodax, Jose Bernardo Quintos
Systemic pseudohypoaldosteronism (PHA) type I is a rare genetic disorder resulting from mutations in the subunits of the epithelial sodium channel that manifests as severe salt wasting, hyperkalemia, and metabolic acidosis in infancy. In this article we report a patient with systemic PHA type I presenting with severe dehydration due to salt wasting at 6 days of life. She was found to have a known mutation in the SCNN1A gene and subsequently required treatment with sodium supplementation. We also review the clinical presentation, differential diagnosis, and treatment of systemic PHA type I and summarize data from 27 cases with follow-up data...
2017: Case Reports in Pediatrics
https://www.readbyqxmd.com/read/28472793/spironolactone-for-the-treatment-of-acne-a-4-year-retrospective-study
#13
Radhika Grandhi, Ali Alikhan
Prior studies have demonstrated that spironolactone is an effective second-line treatment option for postadolescent acne, but has notable side effects. Data are, however, limited. We therefore present a 4-year retrospective study evaluating 291.5 patient-years of spironolactone for the treatment of acne. Our results showed that 86% of patients improved on spironolactone therapy. Further, patients who improved showed minimal side effects, supporting recent evidence that spironolactone is a safe option for acne treatment with a low risk of short-term adverse effects such as hyperkalemia...
May 5, 2017: Dermatology: International Journal for Clinical and Investigative Dermatology
https://www.readbyqxmd.com/read/28471687/the-dilemma-of-dual-renin-angiotensin-system-blockade-in-chronic-kidney-disease-why-beneficial-in-animal-experiments-but-not-in-the-clinic
#14
V Čertíková Chábová, L Červenka
Drugs interfering with the renin-angiotensin-aldosterone system (RAAS) improved the prognosis in patients with hypertension, heart failure, diabetes and chronic kidney disease. However, combining different drugs brought no further benefit while increasing the risk of hyperkalemia, hypotension and acute renal failure. This was so with combining angiotensin converting enzyme inhibitors (ACEi) and angiotensin II receptors type 1 antagonists (ARB). Dissimilarly, in animal disease models this dual therapy proved clearly superior to single drug treatment and became the optimal standard regime for comparison with other treatments...
May 4, 2017: Physiological Research
https://www.readbyqxmd.com/read/28463019/fatal-cardiac-glycoside-poisoning-due-to-mistaking-foxglove-for-comfrey
#15
I-Lin Wu, Jiun-Hao Yu, Chih-Chuan Lin, Chen-June Seak, Kent R Olson, Hsien-Yi Chen
CONTEXT: Accidental ingestion of foxglove (Digitalis purpurea) can cause significant cardiac toxicity. We report a patient who ingested foxglove mistaking it for comfrey and developed refractory ventricular arrhythmias. The patient died despite treatment with digoxin-specific antibody fragments (DSFab) and veno-arterial extracorporeal membrane oxygenation (VA-ECMO). CASE DETAILS: A 55-year-old woman presented to the emergency department with nausea, vomiting and generalized weakness eight hours after drinking "comfrey" tea...
May 2, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28458337/outcomes-analysis-of-surgical-and-medical-treatments-for-patients-with-primary-aldosteronism
#16
Kyeong Seon Park, Jung Hee Kim, Ye Seul Yang, A Ram Hong, Dong-Hwa Lee, Min Kyong Moon, Sung Hee Choi, Chan Soo Shin, Sang Wan Kim, Seong Yeon Kim
Patients with aldosterone-producing adenomas are treated using surgery, and patients with idiopathic hyperaldosteronism receive medical treatment using mineralocorticoid receptor antagonists (MRAs). However, the outcomes of surgical and medical treatment for primary aldosteronism (PA) remain unclear. Therefore, we compared the outcomes of surgical and medical treatment for PA and aimed to identify a specific subgroup that might benefit from medical treatment. We identified 269 patients who were treated for PA (unilateral excess: 221 cases; bilateral excess: 48 cases) during 2000-2015 at the Seoul National University Hospital and two other tertiary centers...
April 29, 2017: Endocrine Journal
https://www.readbyqxmd.com/read/28456777/short-term-changes-of-serum-potassium-concentration-induced-by-physical-exercise-in-patient-with-arterial-hypertension-treated-with-angiotensin-converting-enzyme-inhibitor-alone-or-in-combination-with-statin
#17
P Deska, M Nowicki
Intensive physical exercise may facilitate potassium release from skeletal muscles that may result in hyperkalemia. Commonly used drugs including angiotensin converting enzyme inhibitors (ACEI) and statins increase a risk of hyperkalemia. It is not known whether the effect of these drugs on serum potassium during physical exercise is additive. The study compared the effect of physical exercise on the changes of serum potassium in hypertensive patients receiving ACEI alone or in combination with statin. Eighteen patients with arterial hypertension with normal renal function were included in a prospective placebo-controlled cross-over study...
February 2017: Journal of Physiology and Pharmacology: An Official Journal of the Polish Physiological Society
https://www.readbyqxmd.com/read/28451852/mineralocorticoid-receptor-blockade-in-end-stage-renal-disease
#18
REVIEW
Radmila Lyubarova, Elvira O Gosmanova
PURPOSE OF REVIEW: The purpose of this study was to summarize recent findings about cardiovascular benefits and safety of aldosterone blockade in patients with end-stage renal disease (ESRD). RECENT FINDINGS: It is now well recognized that aldosterone's deleterious cardiovascular impact is not limited to its pressor effect arising from an increase in sodium reabsorption in the kidneys. Aldosterone has also been shown to increase blood pressure by a direct activation of the sympathetic nervous system, to cause endothelial and vascular smooth muscle cell dysfunction, myocardial remodeling and fibrosis, and to have pro-arrhythmogenic actions in the heart...
May 2017: Current Hypertension Reports
https://www.readbyqxmd.com/read/28449154/dual-raas-blockade-with-aliskiren-in-patients-with-severely-impaired-chronic-kidney-disease
#19
Franz Maximilian Rasche, Claudia Joel, Thomas Ebert, Thomas Frese, Filip Barinka, Volker Busch, Wilma Gertrud Rasche, Tom H Lindner, Jochen Schneider, Stephan Schiekofer
Dual renin-angiotensin-aldosterone blockade (dRAASb) is purposed in the prevention of the cardiorenal syndrome (CRS). However, all attempts with dRAASb even in patients with moderate impaired chronic kidney disease (CKD) were terminated due to the typical severe adverse events (SAE), e. g., hyperkalemia and rise of serum creatinine. The aim of our study with the direct renin inhibitor aliskiren was to evaluate the effect of dRAASb with a washout phase in patients with severely advanced CKD. We have studied 45 patients (G3b to 4, A2 and >A3; median glomerular filtration rate (GFR) CKD-EPI 31 (23-40) ml/min per 1...
April 27, 2017: Experimental and Clinical Endocrinology & Diabetes
https://www.readbyqxmd.com/read/28448323/hyperkalemia-after-laparoscopic-nephrectomy-in-patients-with-renal-insufficiency-a-case-report
#20
Frank J Penna, Hiep T Nguyen, Constance S Houck
Laparoscopic surgery is an evolving surgical modality in children, which has been applied to increasingly more complex surgeries and patients, including patients with renal insufficiency. These patients are particularly susceptible to the challenges that laparoscopy imposes on their altered physiology, leading to marked electrolyte disturbances, including metabolic acidosis and hyperkalemia. Hyperkalemia has the potential for marked impairment of cardiac conduction. We report 2 cases where significant, potentially lethal hyperkalemia developed during laparoscopic nephrectomy in adolescents with renal insufficiency...
April 26, 2017: A & A Case Reports
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