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Mirza Sultan Ahmad, Danial Ahmad, Naila Medhat, Syed Aizaz Hussain Zaidi, Hadia Farooq, Sair Ahmad Tabraiz
OBJECTIVE: To ascertain the frequency of electrolyte abnormalities in patients of probable and culture-proven sepsis on admission and assess any association of electrolyte disorders with mortality. STUDY DESIGN: Descriptive study. PLACE AND DURATION OF STUDY: NICU, Fazle-Omar Hospital, Rabwah, from October 2015 to September 2016. METHODOLOGY: All neonates with the diagnosis of probable and culture-proven sepsis during the study period admitted in NICU, Fazle-Omar Hospital, were included in the study...
March 2018: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
R Manipriya, B Umamaheswari, A Prakash, N Binu
Pseudohypoaldosteronism (PHA) Type 1 is characterized by mineralocorticoid resistance, manifesting as neonatal salt wasting, hypotension, hyperkalemia, hyponatremia, and metabolic acidosis in spite of elevated aldosterone levels and plasma renin activity. It is important to differentiate children with systemic PHA from renal PHA, as these children are likely to decompensate even with mild symptoms. Here, we report two neonates with PHA that presented to us with multiorgan involvement.
January 2018: Indian Journal of Nephrology
Mohammad Raffat Jaber, Amr El-Sergany, Ankur Gupta, Carlos E Donayre, Rodney A White, David P Tahour
No abstract text is available yet for this article.
March 1, 2018: Journal of Vascular Access
Yoon-Myung Kim, Go Hun Seo, Gu-Hwan Kim, Jung Min Ko, Jin-Ho Choi, Han-Wook Yoo
BACKGROUND: Adrenal hypoplasia is a rare congenital disorder, which can be classified into a non-syndromic form, without extra-adrenal features, and a syndromic form, with such features. Despite biochemical and molecular genetic evaluation, etiologic diagnosis cannot be performed in many patients with adrenal hypoplasia. CASE PRESENTATION: The patient in this case was a boy born at 31 weeks of gestation with a weight of 882 g (< 3rd percentile) to non-consanguineous parents...
March 5, 2018: BMC Medical Genetics
Jay Ian Lakkis, Matthew R Weir
PURPOSE OF REVIEW: Hyperkalemia develops in a patient with systemic arterial hypertension (HTN) if one or more risk factors are present, namely chronic kidney disease (CKD) (especially severe stage 4-5 CKD), diabetes mellitus (DM), heart failure (HF), or pharmacological therapies that interfere with potassium homeostasis, mainly through renin-angiotensin-aldosterone inhibition (RAASi). Hyperkalemia is a considerable reason of morbidity (emergency department (ED) visits and hospitalizations) and portends a higher mortality risk in patients at risk; for instance, hyperkalemia increases the risk of mortality within 1 day of a hyperkalemic event...
March 1, 2018: Current Cardiology Reports
Christian H Pfob, Matthias Eiber, Peter Luppa, Florian Maurer, Tobias Maurer, Robert Tauber, Calogero D'Alessandria, Benedikt Feuerecker, Klemens Scheidhauer, Armin Ott, Uwe Heemann, Markus Schwaiger, Christoph Schmaderer
BACKGROUND: Amino acid co-infusion for renal protection in endoradiotherapy (ERT) applied as prostate-specific membrane antigen (PSMA)-targeted radioligand therapy (RLT) or peptide receptor radionuclide therapy (PRRT) has been shown to cause severe hyperkalemia. The pathophysiology behind the rapid development of hyperkalemia is not well understood. We hypothesized that the hyperkalemia should be associated with metabolic acidosis. RESULTS: Twenty-two patients underwent ERT...
February 27, 2018: EJNMMI Research
Peng Wu, Zhong-Xiuzi Gao, Xin-Peng Duan, Xiao-Tong Su, Ming-Xiao Wang, Dao-Hong Lin, Ruimin Gu, Wen-Hui Wang
AT2R (AngII [angiotensin II] type 2 receptor) is expressed in the distal nephrons. The aim of the present study is to examine whether AT2R regulates NCC (Na-Cl cotransporter) and Kir4.1 of the distal convoluted tubule. AngII inhibited the basolateral 40 pS K channel (a Kir4.1/5.1 heterotetramer) in the distal convoluted tubule treated with losartan but not with PD123319. AT2R agonist also inhibits the K channel, indicating that AT2R was involved in tonic regulation of Kir4.1. The infusion of PD123319 stimulated the expression of tNCC (total NCC) and pNCC (phosphorylated NCC; Thr53 ) by a time-dependent way with the peak at 4 days...
February 26, 2018: Hypertension
Autumn N Harris, P Richard Grimm, Hyun-Wook Lee, Eric Delpire, Lijuan Fang, Jill W Verlander, Paul A Welling, I David Weiner
Background Hyperkalemia in association with metabolic acidosis that are out of proportion to changes in glomerular filtration rate defines type 4 renal tubular acidosis (RTA), the most common RTA observed, but the molecular mechanisms underlying the associated metabolic acidosis are incompletely understood. We sought to determine whether hyperkalemia directly causes metabolic acidosis and, if so, the mechanisms through which this occurs. Methods We studied a genetic model of hyperkalemia that results from early distal convoluted tubule (DCT)-specific overexpression of constitutively active Ste20/SPS1-related proline-alanine-rich kinase (DCT-CA-SPAK)...
February 26, 2018: Journal of the American Society of Nephrology: JASN
Gul Hassan Sethar, Aisha Almoghawi, Nargis Khan, Wehad Altourah, Najat Mohammed Ashour
Pseudohypoaldosteronism (PHA) type II is an extremely rare disorder which presents with hypertension, hyperkalemia, and normal anion gap metabolic acidosis. PHA II is also known as familial hyperkalemic hypertension, Gordon syndrome, and chloride shunt syndrome. PHA II is an autosomal dominant disorder and is caused by mutation in WNK1, WNK4, CULLIN3, KLHL3, OSR, SPAK gene. The expression of these proteins is limited to the distal convoluted tube and collecting duct of the kidney. PHA II usually responds to salt restriction and thiazide diuretics...
March 2018: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
Krister Bamberg, Ulrika Johansson, Karl Edman, Lena William-Olsson, Susanna Myhre, Anders Gunnarsson, Stefan Geschwindner, Anna Aagaard, Anna Björnson Granqvist, Frédéric Jaisser, Yufeng Huang, Kenneth L Granberg, Rasmus Jansson-Löfmark, Judith Hartleib-Geschwindner
Excess mineralocorticoid receptor (MR) activation promotes target organ dysfunction, vascular injury and fibrosis. MR antagonists like eplerenone are used for treating heart failure, but their use is limited due to the compound class-inherent hyperkalemia risk. Here we present evidence that AZD9977, a first-in-class MR modulator shows cardio-renal protection despite a mechanism-based reduced liability to cause hyperkalemia. AZD9977 in vitro potency and binding mode to MR were characterized using reporter gene, binding, cofactor recruitment assays and X-ray crystallopgraphy...
2018: PloS One
Tomáš Šálek
Hyperkalemia is a potentially lethal condition. Pseudohyperkalemia should be always excluded before implementing treatment to prevent inappropriate cause of hypokalemia - equally a potentially lethal condition. Here we present a case report of a 62 year female with chronic myeloproliferative disorder, i.e. essential thrombocythemia. The laboratory test results for potassium concentration were 6.3 mmol/L, for platelet count 1305 x109 /L and for leukocyte count 39.8 x109 /L. This was due to a temporary drug withdrawal after a surgical intervention for gastric bleeding...
February 15, 2018: Biochemia Medica: časopis Hrvatskoga Društva Medicinskih Biokemičara
Dieter Adelmann, Andrea Olmos, Linda L Liu, John R Feiner, Garrett R Roll, Lyle Burdine, Mehdi Tavakol, Shareef Syed, Babak J Orandi, Claus U Niemann
BACKGROUND: Renal failure is common among patients undergoing liver transplantation. Liver allocation based on the MELD score has increased the number of recipients who require perioperative RRT. Although renal replacement therapy (RRT) can be continued intraoperatively, the risks and benefits of intraoperative RRT are not well defined. The aim of this study is to report the intraoperative management of patients with pretransplant renal failure at a transplant center with extremely infrequent utilization of intraoperative RRT...
February 20, 2018: Transplantation
Caroline Blanc, Pierre-Yves Martin
Hyperkaliaemia is a serious electrolyte disorder that is favored by many comorbidities, such as chronic renal failure or some treatments such as renin-angiotensin-aldosterone system blockers. The new oral treatments by chelation of intestinal potassium have demonstrated : 1) their effectiveness in the management of serum potassium by maintaining the treatments at optimal dosages ; 2) their safety of use by the absence of serious side effect and 3) the ease of use with a daily intake.
February 21, 2018: Revue Médicale Suisse
Funda Karbek Akarca, Ozge Can, Sercan Yalcinli, Yusuf Ali Altunci
Owing to the advancements in medicine, new information is obtained regarding cancer, new antineoplastic agents are developed. Frequent use of these new pharmacological agents emergency physicians to be vigilant about their side effects. We present a case of adrenal crisis in a patient with non-small cell lung cancer (NSCLC), caused by an immunomodulatory drug; nivolumab. While adverse events are related to other immunomodulatory drugs have been reported in literature, our case is the first nivolumab-related adrenal failure to be reported...
December 2017: Turkish Journal of Emergency Medicine
C Chazot, G Jean, D Joly
Patients with Chronic Kidney Disease (CKD) are at risk of various metabolic complications, which can lead to health issues and even be life-threatening if not correctly treated, whereas they can be anticipated. Through clinical cases of patients taken from the daily practice, we propose to look into three of these common complications, namely hypocalcemia, hyperkalemia and metabolic acidosis. From the diagnostic approach to the patient care, these cases provide the opportunity to recall the fundamentals of these disorders and to present the recent literature date enlightening the knowledge related to them...
June 2017: Néphrologie & Thérapeutique
P Rossignol, L Juillard
Hypertension is common in patients with chronic renal disease particularly those with diabetes. It is sometimes resistant to the pharmacological treatment. The mineralocorticoid receptor antagonist spironolactone may be indicated here. The mineralocorticoid receptor antagonists have a Class 1, Level A indication for the treatment of heart failure with reduced ejection fraction. There is an associated risk of worsening renal function and of hyperkalemia which does not hinder their clinical benefit. However, an appropriate biological monitoring is warranted, along with potential dose adaptations...
June 2017: Néphrologie & Thérapeutique
Sarah E Donoghue, James J Pitt, Avihu Boneh, Susan M White
BACKGROUND: Smith-Lemli-Opitz syndrome (SLOS) is an autosomal recessive disorder caused by mutations in the DHCR7 gene that result in reduced cholesterol biosynthesis. The aim of the study was to examine the biochemical and clinical features of SLOS in the context of the emerging evidence of the importance of cholesterol in morphogenesis and steroidogenesis. METHODS: We retrospectively reviewed the records of 18 patients (including four fetuses) with confirmed SLOS and documented their clinical and biochemical features...
February 19, 2018: Journal of Pediatric Endocrinology & Metabolism: JPEM
Kenichi Tanaka, Hiroko Mori, Rieko Sakamoto, Shirou Matsumoto, Hiroshi Mitsubuchi, Kimitoshi Nakamura, Masanori Iwai
BACKGROUND: Neonatal nonoliguric hyperkalemia (NOHK) is a metabolic abnormality that occurs in extremely premature neonates at approximately 24 h after birth and is mainly due to the immature functioning of the sodium (Na + )/potassium (K + ) pump. Magnesium sulfate is frequently used in obstetrical practice to prevent preterm labor and to treat preeclampsia; this medication can also cause hypermagnesemia and hyperkalemia by a mechanism that is different from that of NOHK. Herein, we report the first case of very early-onset neonatal hyperkalemia induced by maternal hypermagnesemia...
February 13, 2018: BMC Pediatrics
Hrishikesh Hazarika, Anudeep Saxena, Pradeep Meshram, Ajay Kumar Bhargava
Purpose: Several devices are available to take care of difficult airway, but C-MAC D-Blade has scant evidence of its use in nasotracheal intubation in a difficult airway scenario. Aims and Objectives: We compared the C-MAC D-Blade videolaryngoscope™ , and the standard Macintosh laryngoscope for nasal intubation in patients with difficult airways selected by El-Ganzouri risk index using parameters of time and attempts required for intubation, glottic view in terms of Cormack-Lehane grade, ease of intubation, success rate, use of accessory maneuvers, incidence of complications, and hemodynamic changes...
January 2018: Saudi Journal of Anaesthesia
Fahmida Chowdhury, Probir Kumar Ghosh, K M Shahunja, Abu S M S B Shahid, Lubaba Shahrin, Monira Sarmin, Sharifuzzaman, Farzana Afroze, Mohammod Jobayer Chisti
Objectives. We sought to evaluate the admission and hospital risk factors for death in children with diarrhea requiring mechanical ventilation (MV). Methods. This was a retrospective study. We enrolled children aged 0 to 59 months admitted with diarrhea to the intensive care unit of the Dhaka Hospital of International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b) between August 2009 and July 2013 and required MV. To evaluate the risk factors for death in MV, we compared the clinical and laboratory characteristics of the children requiring MV...
2018: Global Pediatric Health
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