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Hyperkalemia

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https://www.readbyqxmd.com/read/28721327/two-catastrophes-in-one-patient-drug-reaction-with-eosinophilia-and-systemic-symptoms-and-toxic-shock-syndrome
#1
Moayed Ibrahim, Diana L Nunley
A 70-year-old, immunocompromised patient presented to the emergency room (ER) five weeks after she was started on clopidogrel. She complained of skin eruption, mouth ulcers, fatigue, and myalgia over the past two weeks. Labs showed severe hyponatremia, acute kidney injury, rhabdomyolysis, hyperkalemia, and elevated liver enzymes. She was treated with steroids and discharged after her condition improved. However, a month later, she returned to the ER, complaining of nausea, vomiting, diarrhea, dizziness, chills, and shortness of breath over the past two days...
June 15, 2017: Curēus
https://www.readbyqxmd.com/read/28717776/a-retrospective-study-of-emergency-department-potassium-disturbances-severity-treatment-and-outcomes
#2
Adam J Singer, Henry C Thode, W Frank Peacock
OBJECTIVE: Disturbances in potassium (K) levels are relatively common and may be associated with significant morbidity and mortality; however, treatments vary. Our purpose was to determine the incidence, treatments, and outcomes associated with hyperkalemia and hypokalemia in emergency department (ED) patients. METHODS: We performed a structured, retrospective review of electronic medical records of consecutive adult ED patients with K measured while in the ED. Demographic, clinical, and laboratory data as well as treatments, disposition, and in-hospital complications were collected...
June 2017: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/28710615/aldosterone-antagonist-therapy-and-its-relationship-with-inflammation-fibrosis-thrombosis-mineral-bone-disorder-and-cardiovascular-complications-in-peritoneal-dialysis-pd-patients
#3
Rafał Donderski, Paweł Stróżecki, Beata Sulikowska, Magdalena Grajewska, Ilona Miśkowiec, Anna Stefańska, Joanna Siódmiak, Grażyna Odrowąż-Sypniewska, Jacek Manitius
BACKGROUND: High aldosterone level may contribute to pathogenesis of hypertension, vessels damage and cardiovascular system deterioration in chronic kidney disease patients. Besides its classical action via mineralocorticoid receptor, aldosterone is also involved in cell growth, inflammation, oxidative stress, endothelial dysfunction and exerts fibroproliferative effects. The aim of the study was to assess whether aldosterone antagonist treatment may influence serum level of inflammatory, fibrosis, thrombosis and mineral-bone metabolism markers in peritoneal dialysis (PD) patients and blood pressure, aortic stiffness, echocardiographic indices after 12 months of treatment...
July 14, 2017: International Urology and Nephrology
https://www.readbyqxmd.com/read/28707341/impact-of-hyperkalemia-and-worsening-renal-function-on-the-use-of-renin-angiotensin-aldosterone-system-inhibitors-in-chronic-heart-failure-with-reduced-ejection-fraction
#4
B Pitt, P Rossignol
Patients with heart failure (HF) and reduced ejection fraction (HFREF) are at increased risk of death and hospitalizations for HF. Numerous registries have reported a large and persistent gap between real-life practice in the use of life-saving evidence-based therapies, such as renin angiotensin system inhibitors, beta blockers, mineralocorticoid receptor antagonists (MRAs), and recommended practices in international guidelines. The fears of inducing hyperkalemia and/or worsening renal function are the main triggers of this underuse...
July 14, 2017: Clinical Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/28705920/nephron-remodeling-underlies-hyperkalemia-in-familial-hyperkalemic-hypertension
#5
EDITORIAL
James A McCormick, David H Ellison
No abstract text is available yet for this article.
July 13, 2017: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/28702139/ramipril-associated-cholestasis-in-the-setting-of-recurrent-drug-induced-liver-injury
#6
David Forner, Tasha Kulai, Thomas Arnason, Steven E Gruchy, Magnus MacLeod
Aim: Angiotensin-converting enzyme inhibitors (ACEIs) are commonly used to treat hypertension. Although generally well tolerated, the adverse effects of ACEIs include hypotension, cough, acute kidney injury and hyperkalemia. Rare reports of ACEI-induced hepatotoxicity have been described, most notably a cholestatic pattern of injury related to captopril. A 67-year-old male presented to the emergency department with a three-week history of jaundice, pruritis and weakness. Eight weeks before, he began taking ramipril and clopidogrel...
2017: Gastroenterology and Hepatology From Bed to Bench
https://www.readbyqxmd.com/read/28700781/efficacy-and-safety-of-spironolactone-in-acute-heart-failure-the-athena-hf-randomized-clinical-trial
#7
Javed Butler, Kevin J Anstrom, G Michael Felker, Michael M Givertz, Andreas P Kalogeropoulos, Marvin A Konstam, Douglas L Mann, Kenneth B Margulies, Steven E McNulty, Robert J Mentz, Margaret M Redfield, W H Wilson Tang, David J Whellan, Monica Shah, Patrice Desvigne-Nickens, Adrian F Hernandez, Eugene Braunwald
Importance: Persistent congestion is associated with worse outcomes in acute heart failure (AHF). Mineralocorticoid receptor antagonists administered at high doses may relieve congestion, overcome diuretic resistance, and mitigate the effects of adverse neurohormonal activation in AHF. Objective: To assess the effect of high-dose spironolactone and usual care on N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels compared with usual care alone. Design, Setting, and Participants: This double-blind and placebo (or low-dose)-controlled randomized clinical trial was conducted in 22 US acute care hospitals among patients with AHF who were previously receiving no or low-dose (12...
July 12, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28697495/electrolyte-and-acid-base-abnormalities-in-infants-with-community-acquired-acute-pyelonephritis-prospective-cross-sectional-study
#8
Gregorio P Milani, Angela Grava, Mario G Bianchetti, Sebastiano A G Lava, Laura Dell'Era, Thomas Teatini, Emilio F Fossali
BACKGROUND: Retrospective case series suggest that abnormalities in fluid, electrolyte, and acid-base homeostasis may occur among infants with a febrile urinary tract infection. Potentially inaccurate laboratory methods of sodium testing have often been used. METHODS: Between January 2009 and June 2016, we managed 80 previously healthy infants (52 males and 28 females) ≥4 weeks to ≤24 months of age with their first episode of acute pyelonephritis. Ionized sodium, ionized potassium and ionized chloride were determined by direct potentiometry, as recommended by the International Federation of Clinical Chemistry...
July 12, 2017: Nephron
https://www.readbyqxmd.com/read/28659399/confusing-hyperkalemia
#9
Anne-Elisabeth Manteaux, Imad Dali-Braham, Laurent Ramont, François-Xavier Maquart, Jean-Baptiste Oudart
No abstract text is available yet for this article.
July 2017: Clinical Chemistry
https://www.readbyqxmd.com/read/28656517/treatment-of-hyperkalemia-in-heart-failure
#10
REVIEW
Ersilia M DeFilippis, Akshay S Desai
PURPOSE OF REVIEW: The aim of this paper is to discuss strategies for prevention and management of hyperkalemia in patients with heart failure, including the role of novel therapies. RECENT FINDINGS: Renin-angiotensin-aldosterone system (RAAS) antagonists, including angiotensin-converting enzyme inhibitors (ACEI), angiotensin receptor blockers (ARB), and mineralocorticoid receptor antagonists (MRA) decrease mortality and morbidity in heart failure but increase the risk of hyperkalemia, especially when used in combination...
June 27, 2017: Current Heart Failure Reports
https://www.readbyqxmd.com/read/28652957/a-retrospective-study-of-acute-renal-failure-in-children-its-incidence-etiology-complications-and-prognosis
#11
Kadar Ismail Hassan, Jama Hodan M, Chunfu Li
BACKGROUND: Acute renal failure (ARF) developed due to various causes and may lead to significant morbidity and mortality among pediatric patients. OBJECTIVES: The study was conducted to determine the incidence, etiology, outcome of treatment and clinical presentation of ARF in pediatric patients in Somalia. METHODS: Comprehensive case history of 39 pediatric patients below 12 years of age, admitted with renal diseases in four tertiary care hospitals in Hargeisa and Borama cities in Somalia during December 2015 to November 2016...
May 25, 2017: Curēus
https://www.readbyqxmd.com/read/28652800/nutritional-status-among-peritoneal-dialysis-patients-after-oral-supplement-with-once-dialyze-formula
#12
Bancha Satirapoj, Pokkrong Limwannata, Chadarat Kleebchaiyaphum, Janjira Prapakorn, Ussanee Yatinan, Samitti Chotsriluecha, Ouppatham Supasyndh
BACKGROUND: Malnutrition is an important problem in patients treated with long-term dialysis, and most dialysis patients have lower dietary energy and protein intake. This study was undertaken to examine whether orally administered Otsuka Nutrition Pharmaceutical (ONCE) dialyze formula (ODF) supplement would improve energy intake without mineral and electrolyte disturbances in patients with continuous ambulatory peritoneal dialysis (CAPD). METHODS: The effects of ODF supplementation on nutrition markers including serum albumin and prealbumin concentrations and inflammatory stress in patients with chronic CAPD were evaluated...
2017: International Journal of Nephrology and Renovascular Disease
https://www.readbyqxmd.com/read/28640781/hydrogen-gas-inhalation-inhibits-progression-to-the-irreversible-stage-of-shock-after-severe-hemorrhage-in-rats
#13
Tadashi Matsuoka, Masaru Suzuki, Motoaki Sano, Kei Hayashida, Tomoyoshi Tamura, Koichiro Homma, Keiichi Fukuda, Junichi Sasaki
BACKGROUND: Mortality of hemorrhagic shock primarily depends on whether or not the patients can endure the loss of circulating volume until radical treatment is applied. We investigated whether hydrogen (H2) gas inhalation would influence the tolerance to hemorrhagic shock and improve survival. METHODS: Hemorrhagic shock was achieved by withdrawing blood until the mean arterial blood pressure reached 30-35 mmHg. After 60 minutes of shock, the rats were resuscitated with a volume of normal saline equal to four times the volume of shed blood...
June 20, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28638567/nephrology-key-information-for-internists
#14
Sohail Abdul Salim, Juan A Medaura, Bharat Malhotra, Vishnu Garla, Shradha Ahuja, Nicki Lawson, Amaleswari Pamarthy, Hardik Sonani, Karthik Kovvuru, Venkataraman Palabindala
Hospitalists and primary care physicians encounter renal disease daily. Although most cases of acute kidney injury (AKI) are secondary to dehydration and resolve by giving fluids, many cases of AKI are due to not uncommon but unfamiliar causes needing nephrology evaluation. Common indications to consult a nephrologist on an emergency basis include hyperkalemia or volume overload in end stage renal disease patients (ESRD). Other causes of immediate consultation are cresenteric glomerulonephritis / rapidly progressive glomerulonephritis in which renal prognosis of the patient depends on timely intervention...
March 2017: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/28622150/intraoperative-hyperkalemia-and-ventricular-arrhythmia-during-parathyroidectomy-a-case-report
#15
Daniel J Rosenkrans, Lavinia M Kolarczyk
We present a case of acute hyperkalemia and ventricular arrhythmia during parathyroidectomy in a patient with end-stage renal disease. This case highlights the under-recognized alterations in potassium homeostasis associated with parathyroidectomy and underscores the importance of preoperative optimization.
June 15, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28618426/renoprotective-effect-of-angiotensin-converting-enzyme-inhibitors-and-angiotensin-ii-receptor-blockers-in-diabetic-patients-with-proteinuria
#16
Feng-Yi Hsu, Fang-Ju Lin, Huang-Tz Ou, Shih-Hui Huang, Chi-Chuan Wang
BACKGROUND/AIMS: Limited evidence exists on the choice of angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs) in diabetic patients with nephropathy. We aim to assess the renal effectiveness and safety of these drugs among diabetic nephropathy patients. METHODS: This retrospective cohort study was conducted with diabetic nephropathy patients who initiated ACEI or ARB monotherapy. The primary outcome was a composite of end stage of renal disease and renal transplantation, and the secondary outcome was all-cause mortality...
2017: Kidney & Blood Pressure Research
https://www.readbyqxmd.com/read/28614052/safety-of-the-neprilysin-renin-angiotensin-system-inhibitor-lcz696
#17
REVIEW
Bo Li, Yunhe Zhao, Bo Yin, Mengfei Helian, Xinmei Wang, Feng Chen, Hongxia Zhang, Hui Sun, Bin Meng, Fengshuang An
OBJECTIVES: The combined neprilysin/rennin-angiotensin system inhibitor sacubitril/valsartan (LCZ696) has shown its superiority over ACEI/ARB therapy. In view of the existing concern of its adverse effects, we aimed to provide evidence of the safety of the new drug. RESULTS: A total of 6 randomized trials with 11,821 subjects were included in this analysis. No significant differences were found in any adverse effects between LCZ696 and ACEI/ARB or placebo groups...
May 31, 2017: Oncotarget
https://www.readbyqxmd.com/read/28611786/spironolactone-treatment-and-effect-on-survival-in-chronic-heart-failure-patients-with-reduced-renal-function-a-propensity-matched-study
#18
Viera Stubnova, Ingrid Os, Morten Grundtvig, Dan Atar, Bård Waldum-Grevbo
BACKGROUND/AIMS: Spironolactone may be hazardous in heart failure (HF) patients with renal dysfunction due to risk of hyperkalemia and worsened renal function. We aimed to evaluate the effect of spironolactone on all-cause mortality in HF outpatients with renal dysfunction in a propensity-score-matched study. METHODS: A total of 2,077 patients from the Norwegian Heart Failure Registry with renal dysfunction (eGFR <60 mL/min/1.73 m(2)) not treated with spironolactone at the first visit at the HF clinic were eligible for the study...
February 2017: Cardiorenal Medicine
https://www.readbyqxmd.com/read/28608260/water-electrolyte-acid-base-and-trace-elements-alterations-in-cirrhotic-patients
#19
REVIEW
Carlos G Musso, Rossina Juarez, Richard J Glassock
Chronic hepatic patients, and particularly those suffering from cirrhosis, are predisposed to different sort of water, electrolyte, acid-base, and trace elements disorders due to their altered liver function, and also to their exposition to infectious, inflammatory, oncologic, and pharmacologic variables whose combination undermines their homeostatic capability. Hyponatremia, hypokalemia, hyperkalemia, hypocalcemia, metabolic acidosis, respiratory, and metabolic alkalosis are the main internal milieu alterations in this group...
June 12, 2017: International Urology and Nephrology
https://www.readbyqxmd.com/read/28603943/tachycardia-dependent-brugada-phenocopy-due-to-hyperkalemia
#20
Raed Abu Shama, Antoni Bayes de Luna, Adrian Baranchuk
No abstract text is available yet for this article.
June 12, 2017: Journal of Cardiovascular Electrophysiology
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