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Hyperkalemia

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https://www.readbyqxmd.com/read/29340313/treatment-of-severe-hyperkalemia-confronting-4-fallacies
#1
REVIEW
J Gary Abuelo
Severe hyperkalemia is a medical emergency that can cause lethal arrhythmias. Successful management requires monitoring of the electrocardiogram and serum potassium concentrations, the prompt institution of therapies that work both synergistically and sequentially, and timely repeat dosing as necessary. It is of concern then that, based on questions about effectiveness and safety, many physicians no longer use 3 key modalities in the treatment of severe hyperkalemia: sodium bicarbonate, sodium polystyrene sulfonate (Kayexalate [Concordia Pharmaceuticals Inc...
January 2018: KI Reports
https://www.readbyqxmd.com/read/29322723/thyrotoxic-channelopathies
#2
Pankaj Singhai, Shruti Krishnan, Vikram Uttam Patil
Thyrotoxic periodic paralysis (TPP), a disorder most commonly seen in Asian men, is characterized by abrupt onset of hypokalemia and paralysis. The condition primarily affects the lower extremities and is secondary to thyrotoxicosis. Early recognition of TPP is vital to initiating appropriate treatment and to avoiding the risk of rebound hyperkalemia that may occur if high-dose potassium replacement is given. Here we present a case of 31 year old male with thyrotoxic periodic paralysis with diagnostic and therapeutic approach...
November 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/29321412/the-successful-treatment-of-sodium-polystyrene-sulfonate-induced-enteritis-diagnosed-by-small-bowel-endoscopy
#3
Kohei Okayama, Yoshikazu Hirata, Daisuke Kumai, Yuki Yamamoto, Yuki Kojima, Takuya Kanno, Hirokazu Ikeuchi, Hisato Mochizuki, Hiroki Takada, Satoshi Sobue
Sodium polystyrene sulfonate (SPS: Kayexalate®) is an ion-exchange resin used to treat hyperkalemia in patients with chronic kidney disease. It is known that this resin sometimes causes colonic necrosis and perforation, but there are few reports about small bowel necrosis associated with SPS. We herein report the case of a patient who developed SPS-induced small bowel necrosis, which was diagnosed based on the examination of a small bowel endoscopic biopsy specimen. The SPS-induced small bowel necrosis was resistant to conservative treatment including the cessation of SPS, and finally required surgical bowel resection...
January 11, 2018: Internal Medicine
https://www.readbyqxmd.com/read/29319780/diabetes-mellitus-and-hyperkalemic-renal-tubular-acidosis-case-reports-and-literature-review
#4
Carlos Henrique Pires Ratto Tavares Bello, João Sequeira Duarte, Carlos Vasconcelos
Hyporeninemic hypoaldosteronism, despite being common, remains an underdiagnosed entity that is more prevalent in patients with diabetes mellitus. It presents with asymptomatic hyperkalemia along with hyperchloraemic metabolic acidosis without significant renal function impairment. The underlying pathophysiological mechanism is not fully understood, but it is postulated that either aldosterone deficiency (hyporeninemic hypoaldosteronism) and/or target organ aldosterone resistance (pseudohypoaldosteronism) may be responsible...
October 2017: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
https://www.readbyqxmd.com/read/29311039/sodium-reduced-meat-and-poultry-products-contain-a-significant-amount-of-potassium-from-food-additives
#5
Arti Sharma Parpia, Marc B Goldstein, JoAnne Arcand, France Cho, Mary R L'Abbé, Pauline B Darling
BACKGROUND: Sodium-reduced packaged food products are increasingly available to consumers; however, it is not clear whether they are suitable for inclusion in a potassium-reduced diet. For individuals with impaired renal potassium excretion caused by chronic kidney disease and for those taking certain medications that interfere with the rennin-angiotensin aldosterone axis, the need to limit dietary potassium is important in view of the risk for development of hyperkalemia and fatal cardiac arrhythmias...
January 6, 2018: Journal of the Academy of Nutrition and Dietetics
https://www.readbyqxmd.com/read/29310400/clinical-analysis-of-hyperkalemia-after-esophagectomy-a-case-report
#6
Qiang Chen, Wei-Guo Zhang, Shu-Chang Chen
RATIONALE: The occurrence of hyperkalemia after esophagectomy is clinically rare. Patients who underwent esophagectomy often have a serum potassium level due to perioperative reduced intake, fluids loss, consumption and other reasons. These patients often require the artificial administration of potassium. Rapid fluid loss and physiological consumption lead to the deficiency of potassium, even hypokalemia. Patients often require the addition of a large amount of potassium after operation...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29279937/insulin-dosing-error-in-a-patient-with-severe-hyperkalemia
#7
D Brock Hewitt, Cynthia Barnard, Karl Y Bilimoria
No abstract text is available yet for this article.
December 26, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29278563/recognizing-thyrotoxic-hypokalemic-periodic-paralysis
#8
Kamini Patel, Jonathan V McCoy, Patrick M Davis
Thyrotoxic hypokalemic periodic paralysis (THPP) is a rare but potentially serious complication of thyrotoxicosis. The resulting muscle weakness is profound, associated with more severe hypokalemia, yet reversible. However, clinicians must be cautious because patients can develop life-threatening hyperkalemia during treatment. Underlying causes should be investigated as repeated episodes of THPP may occur.
January 2018: JAAPA: Official Journal of the American Academy of Physician Assistants
https://www.readbyqxmd.com/read/29276256/evaluation-of-insulin-use-and-hypoglycemia-in-hospitalized-elderly-patients
#9
Quyen N Bach, Rod A Gilmore, Melody C Sheffield, W Anthony Hawkins
Background: Routine administration of correctional insulin is no longer recommended as a primary strategy to treat hyperglycemia in hospitalized patients. Studies have demonstrated significant improvement in glycemic control in patients treated with basal and correctional insulin (B+C) versus correctional insulin alone (C). However, the effect of C or B+C on hypoglycemic events is not well understood. Objective: The objective of this study was to investigate the effect of B+C versus C on hypoglycemic events in hospitalized elderly patients...
December 2017: Hospital Pharmacy
https://www.readbyqxmd.com/read/29276100/revisiting-raas-blockade-in-ckd-with-newer-potassium-binding-drugs
#10
Panagiotis I Georgianos, Rajiv Agarwal
Among patients with proteinuric chronic kidney disease (CKD), current guideline recommendations mandate the use of agents blocking the renin angiotensin aldosterone system (RAAS) as first-line antihypertensive therapy based on randomized trials demonstrating that RAAS inhibitors are superior to other antihypertensive drug classes in slowing nephropathy progression to end-stage renal disease. However, the opportunities for adequate RAAS blockade in CKD are often limited, and an important impediment is the risk of hyperkalemia, especially when RAAS inhibitors are used in maximal doses or are combined...
December 21, 2017: Kidney International
https://www.readbyqxmd.com/read/29275368/use-of-mineralocorticoid-receptor-antagonists-in-patients-with-heart-failure-and-comorbid-diabetes-mellitus-or-chronic-kidney-disease
#11
Lauren B Cooper, Steven J Lippmann, Melissa A Greiner, Abhinav Sharma, Jacob P Kelly, Gregg C Fonarow, Clyde W Yancy, Paul A Heidenreich, Adrian F Hernandez
BACKGROUND: Perceived risks of hyperkalemia and acute renal insufficiency may limit use of mineralocorticoid receptor antagonist (MRA) therapy in patients with heart failure, especially those with diabetes mellitus or chronic kidney disease. METHODS AND RESULTS: Using clinical registry data linked to Medicare claims, we analyzed patients hospitalized with heart failure between 2005 and 2013 with a history of diabetes mellitus or chronic kidney disease. We stratified patients by MRA use at discharge...
December 23, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29244647/diagnosis-and-treatment-of-hyperkalemia
#12
REVIEW
Biff F Palmer, Deborah J Clegg
Hyperkalemia results either from the shift of potassium out of cells or from abnormal renal potassium excretion. Cell shift leads to transient increases in the plasma potassium concentration, whereas decreased renal excretion of potassium leads to sustained hyperkalemia. Impairments in renal potassium excretion can be the result of reduced sodium delivery to the distal nephron, decreased mineralocorticoid level or activity, or abnormalities in the cortical collecting duct. In some instances, all 3 of these perturbations are present...
December 2017: Cleveland Clinic Journal of Medicine
https://www.readbyqxmd.com/read/29231239/female-pattern-hair-loss-a-pilot-study-investigating-combination-therapy-with-low-dose-oral-minoxidil-and-spironolactone
#13
Rodney D Sinclair
BACKGROUND: Minoxidil and spironolactone are oral antihypertensives known to stimulate hair growth. OBJECTIVE: To report on a case series of women with pattern hair loss (PHL) treated with once daily minoxidil 0.25 mg and spironolactone 25 mg. METHODS: Women newly diagnosed with a Sinclair stage 2-5 PHL were scored for hair shedding and hair density before and after 12 months of treatment with oral minoxidil 0.25 mg and spironolactone 25 mg...
December 12, 2017: International Journal of Dermatology
https://www.readbyqxmd.com/read/29230244/tumor-lysis-syndrome-in-patients-with-hematological-malignancies
#14
REVIEW
Yohannes Belay, Ketsela Yirdaw, Bamlaku Enawgaw
Tumor lysis syndrome is a metabolic complication that may follow the initiation of cancer therapy. It commonly occurs in hematological malignant patients particularly non-Hodgkin's lymphoma and acute leukemia due to chemotherapy or spontaneously. It is characterized by a biochemical abnormality such as hyperuricemia, hyperkalemia, hyperphosphatemia, and hypocalcemia and its clinical outcome is directly related to these biochemical abnormalities. Prevention and treatment of tumor lysis syndrome depend on immediate recognition of patients at risk...
2017: Journal of Oncology
https://www.readbyqxmd.com/read/29225880/tumor-lysis-syndrome-with-massive-hyperphosphatemia-and-hyperuricemia
#15
Abhilash Koratala
Tumor lysis syndrome (TLS) occurs when tumor cells release their contents into the bloodstream, typically in response to chemotherapy, leading to the characteristic findings of hyperuricemia, hyperkalemia, hyperphosphatemia, hypocalcemia, and acute kidney injury. Twinkle artifacts on renal ultrasound may indicate calcium phosphate deposits in such patients.
December 2017: Clinical Case Reports
https://www.readbyqxmd.com/read/29224647/mineralocorticoid-receptor-antagonists-in-patients-with-acute-myocardial-infarction-a-systematic-review-and-meta-analysis-of-randomized-trials
#16
REVIEW
Matthias Bossard, Yasser Binbraik, Farzin Beygui, Bertram Pitt, Faiez Zannad, Gilles Montalescot, Sanjit S Jolly
BACKGROUND: Although mineralocorticoid antagonists (MRAs) reduce mortality in patients with heart failure complicating myocardial infarction (MI), it is unclear if they could be beneficial to all patients with MI. To evaluate the utility of MRAs in MI patients, we performed a systematic review and meta-analysis. METHODS: MEDLINE, EMBASE, and Cochrane CENTRAL were searched from 1965 to June 2016. Conference abstracts were searched from 2000 to June 2016. Randomized trials evaluating the effect of MRA after MIs were included...
January 2018: American Heart Journal
https://www.readbyqxmd.com/read/29218312/potassium-homeostasis-oxidative-stress-and-human-disease
#17
Udensi K Udensi, Paul B Tchounwou
Potassium is the most abundant cation in the intracellular fluid and it plays a vital role in the maintenance of normal cell functions. Thus, potassium homeostasis across the cell membrane, is very critical because a tilt in this balance can result in different diseases that could be life threatening. Both Oxidative stress (OS) and potassium imbalance can cause life threatening health conditions. OS and abnormalities in potassium channel have been reported in neurodegenerative diseases. This review highlights the major factors involved in potassium homeostasis (dietary, hormonal, genetic, and physiologic influences), and discusses the major diseases and abnormalities associated with potassium imbalance including hypokalemia, hyperkalemia, hypertension, chronic kidney disease, and Gordon's syndrome, Bartter syndrome, and Gitelman syndrome...
2017: International Journal of Clinical and Experimental Physiology
https://www.readbyqxmd.com/read/29216260/angiotensin-receptor-blockers-are-associated-with-lower-mortality-than-ace-inhibitors-in-predialytic-stage-5-chronic-kidney-disease-a-nationwide-study-of-therapy-with-renin-angiotensin-system-blockade
#18
Chih-Ching Lin, Yu-Te Wu, Wu-Chang Yang, Min-Juei Tsai, Jia-Sin Liu, Chi-Yu Yang, Szu-Yuan Li, Shuo-Ming Ou, Der-Cherng Tarng, Chih-Cheng Hsu
Dual renin angiotensin system (RAS) blockade using angiotensin-receptor blockers (ARBs) in combination with angiotensin converting enzyme inhibitors (ACEIs) is reported to improve proteinuria in both diabetic and non-diabetic patients. However, its renoprotective effect and safety remain uncertain in patients with advanced chronic kidney disease (CKD). From January 1, 2000 through June 30, 2009, we enrolled 14,117 pre-dialytic stage 5 CKD patients with serum creatinine >6mg/dL and hematocrit <28% under the treatment with erythropoiesis stimulating agents and RAS blockade...
2017: PloS One
https://www.readbyqxmd.com/read/29208883/tumor-lysis-syndrome-and-hyperleukocytosis-in-childhood-acute-lymphoblastic-leukemia-in-a-tertiary-care-hospital
#19
R Tasmeen, A Islam, S T Alam, M Begum
Acute lymphoblastic leukemia is the most common (77%) childhood leukemia and also the most common neoplastic disease in children. Acute lymphoblastic leukemia initially present with hyperleukocytosis (WBC count more than 50,000/mm³) in twenty percent cases. These children are particularly at risk of development of tumor lysis syndrome (TLS). Tumor lysis syndrome is a metabolic disorder consists of hyperuricaemia, hyperkalemia, hyperphosphataemia, hypocalcaemia with or without renal insufficiency. It is the most common disease related emergency encountered by physicians caring for cancer of children and adult...
October 2017: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/29208032/junior-rounds-an-educational-initiative-to-improve-role-transitions-for-junior-residents
#20
Richard Dunbar-Yaffe, Wayne L Gold, Peter E Wu
OBJECTIVE: At our institution, Morning Report focuses mostly on diagnostic reasoning. This makes it a challenge for first-year residents to learn to manage common on-call emergencies, such as hyperkalemia. We sought to improve their preparedness for the transitions they would encounter: from medical student to physician at the beginning of the academic year, and from junior resident to senior resident toward the end. In response to feedback, we developed the Junior Rounds curriculum: a weekly session focused on the approach to commonly encountered on-call emergencies and internal medicine referrals...
December 6, 2017: BMC Research Notes
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