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https://www.readbyqxmd.com/read/29786183/-hyperkalemia-as-a-limiting-factor-in-the-use-of-drugs-that-block-the-renin-angiotensin-aldosterone-system-raas
#1
Antonio Santoro, Marcora Mandreoli
Angiotensin-converting enzyme (ACE-I) inhibitors and ARBs have shown real efficacy in reducing blood pressure, proteinuria, in slowing the progression of chronic kidney disease (MRC) and in clinical improvement. in patients with heart failure, diabetes mellitus and ischemic heart disease. However, their use is limited by some side effects such as the increase in serum potassium (K), which can be particularly severe in patients with renal insufficiency. In the 23,000 patients followed by the PIRP project of the Emilia-Romagna Region, hyperkalaemia at the first visit (K> 5...
May 2018: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/29767459/long-term-effects-of-patiromer-for-hyperkalaemia-treatment-in-patients-with-mild-heart-failure-and-diabetic-nephropathy-on-angiotensin-converting-enzymes-angiotensin-receptor-blockers-results-from-amethyst-dn
#2
Bertram Pitt, George L Bakris, Matthew R Weir, Mason W Freeman, Mitja Lainscak, Martha R Mayo, Dahlia Garza, Rezi Zawadzki, Lance Berman, David A Bushinsky
AIMS: Chronic kidney disease (CKD) in heart failure (HF) increases the risk of hyperkalaemia (HK), limiting angiotensin-converting enzyme inhibitor (ACE-I) or angiotensin receptor blocker (ARB) use. Patiromer is a sodium-free, non-absorbed potassium binder approved for HK treatment. We retrospectively evaluated patiromer's long-term safety and efficacy in HF patients from AMETHYST-DN. METHODS AND RESULTS: Patients with Type 2 diabetes, CKD, and HK [baseline serum potassium >5...
May 16, 2018: ESC Heart Failure
https://www.readbyqxmd.com/read/29767451/feline-ureteral-obstructions-part-1-medical-management
#3
REVIEW
D L Clarke
Feline ureteral obstructions are an increasingly recognised and challenging diagnostic and management problem. Many cats with ureteral obstructions are critically ill at the time of diagnosis, especially if there is dysfunction of the contralateral kidney. They may present with varying severities of acute kidney injury, electrolyte disturbances, and may have comorbidities such as heart disease that complicate perioperative and long-term management. Medical management, which may consist of rehydration and restoration of intravascular volume with intravenous fluid therapy, osmotic diuresis, ureteral muscle relaxation, and antimicrobials for infection, is important in feline ureteral obstruction patients...
May 16, 2018: Journal of Small Animal Practice
https://www.readbyqxmd.com/read/29757348/a-case-of-undiagnosed-pseudohyperkalaemia-following-a-splenectomy
#4
Marco Grech
Pseudohyperkalaemia is defined as a rise in serum potassium with concomitantly normal plasma potassium. The case of long undiagnosed pseudohyperkalaemia in an 84-year-old lady with thrombocytosis post splenectomy is presented. Presenting a historical perspective and the multifactorial aetiology of pseudohyperkalaemia the author underlines the importance of detecting apparent hyperkalaemia by testing the plasma potassium. Awareness of the possible causes of pseudohyperkalaemia increases the likelihood of it being detected earlier thereby decreasing the risk of harming the patient...
May 11, 2018: Age and Ageing
https://www.readbyqxmd.com/read/29729156/correlations-between-lipid-metabolism-indices-in-patients-with-hypertension-and-hypothyroidism
#5
Lyubov V Olenych, Lesya I Pylypiv, Nataliya S Bek, Olena M Radchenko
OBJECTIVE: Introduction: Hypertension is a major reason behind morbidity, disability and mortality. Elevated blood pressure is a huge risk factor for cardio-vascular diseases. Almost 90% of hypertension patients have internal comorbidities, in particular hypothyroidism. For now, however, the specificities of the clinical course of hypertension in hypothyroid patients are understudied and the data on lipid metabolism in patients with primary hypothyroidism and hypertension are inconclusive...
2018: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/29726985/expert-consensus-document-on-the-management-of-hyperkalaemia-in-patients-with-cardiovascular-disease-treated-with-raas-inhibitors-coordinated-by-the-working-group-on-cardiovascular-pharmacotherapy-of-the-european-society-of-cardiology
#6
Giuseppe M C Rosano, Juan Tamargo, Keld P Kjeldsen, Mitja Lainscak, Stefan Agewall, Stefan D Anker, Claudio Ceconi, Andrew J S Coats, Heinz Drexel, Gerasimos Filippatos, Juan Carlos Kaski, Lars Lund, Alexander Niessner, Gianluigi Savarese, Thomas A Schmidt, Petar Seferovic, Sven Wassmann, Thomas Walther, Basil S Lewis
Renin angiotensin aldosterone system inhibitors/antagonists/blockers (RAASi) are a cornerstone in treatment of patients with cardiovascular diseases especially in those with heart failure (HF) due to their proven effect on surrogate and hard end-points. RAASi are also the basis in treatment of arterial hypertension and they are furthermore indicated to reduce events and target organ damage in patients with diabetes and chronic kidney disease, where they have specific indication because of the evidence of benefit...
May 3, 2018: European Heart Journal. Cardiovascular Pharmacotherapy
https://www.readbyqxmd.com/read/29700176/ecg-in-hyperkalaemia
#7
Arunkumar Panneerselvam
No abstract text is available yet for this article.
April 26, 2018: Postgraduate Medical Journal
https://www.readbyqxmd.com/read/29667759/incidence-predictors-and-clinical-management-of-hyperkalaemia-in-new-users-of-mineralocorticoid-receptor-antagonists
#8
Marco Trevisan, Pietro de Deco, Hairong Xu, Marie Evans, Bengt Lindholm, Rino Bellocco, Peter Barany, Tomas Jernberg, Lars H Lund, Juan J Carrero
BACKGROUND: Concerns for hyperkalaemia limit the use of mineralocorticoid receptor antagonists (MRAs). The frequency of MRA-associated hyperkalaemia in real-world settings and the extent of subsequent MRA discontinuation are poorly quantified. METHODS AND RESULTS: Observational study including all Stockholm citizens initiating MRA therapy during 2007-2010. Hyperkalaemias were identified from all potassium (K+ ) measurements in healthcare. MRA treatment lengths and dosages were obtained from complete collection of pharmacy dispensations...
April 18, 2018: European Journal of Heart Failure
https://www.readbyqxmd.com/read/29587582/spironolactone-to-increase-natriuresis-in-congestive-heart-failure-with-cardiorenal-syndrome
#9
Frederik H Verbrugge, Pieter Martens, Koen Ameloot, Veerle Haemels, Joris Penders, Matthias Dupont, W H Wilson Tang, Walter Droogné, Wilfried Mullens
BACKGROUND: Signs and symptoms of volume overload are the most frequent reason for hospital admission in acute heart failure (AHF). Diuretics are mainstay treatment, but their optimal type and dose regimen remain unclear, especially in patients with cardiorenal syndrome. METHODS: This prospective study aimed to include 80 AHF patients with volume overload and cardiorenal syndrome. Through a 2 × 2 factorial design, patients were randomised towards (1) combinational treatment with acetazolamide and low-dose loop diuretics versus high-dose loop diuretics; and (2) open-label oral spironolactone 25 mg OD given upfront versus at discharge...
March 27, 2018: Acta Cardiologica
https://www.readbyqxmd.com/read/29578280/factors-associated-with-underuse-of-mineralocorticoid-receptor-antagonists-in-heart-failure-with-reduced-ejection-fraction-an-analysis-of-11-215-patients-from-the-swedish-heart-failure-registry
#10
Gianluigi Savarese, Juan-Jesus Carrero, Bertram Pitt, Stefan D Anker, Giuseppe M C Rosano, Ulf Dahlström, Lars H Lund
AIM: Mineralocorticoid receptor antagonists (MRAs) improve outcomes in heart failure with reduced ejection fraction (HFrEF), but are underutilized. Hyperkalaemia may be one reason, but the underlying reasons for underuse are unknown. The aim of this study was to investigate the independent predictors of MRA underuse in a large and unselected HFrEF cohort. METHODS AND RESULTS: We included patients with HFrEF (ejection fraction <40%), New York Heart Association (NYHA) class II-IV and heart failure (HF) duration ≥6 months from the Swedish HF Registry...
March 26, 2018: European Journal of Heart Failure
https://www.readbyqxmd.com/read/29557269/acute-diffuse-alveolar-haemorrhage-accompanied-by-gastrointestinal-bleeding-in-a-patient-with-serious-systemic-lupus-erythematosus-a-case-report
#11
Jing Du, Ying Wang, Yan-Chun Li, Tong-Tong Wang, Yong-Lie Zhou, Zhen-Hua Ying
Systemic lupus erythematosus (SLE) is an autoimmune disease that affects many organs, but multisystem dysfunction is rare. Here, we report a case of a 29-year-old woman who was initially diagnosed with SLE complications including lupus nephritis, lupus encephalopathy, renal hypertension, thrombocytopenia, anaemia and hyperkalaemia. She recovered following treatment with high dose methylprednisolone, intravenous immunoglobulin (IVIG) and continuous renal replacement therapy (CRRT). However, a few days after hospital discharge, she developed gastrointestinal bleeding...
January 1, 2018: Journal of International Medical Research
https://www.readbyqxmd.com/read/29554312/serum-potassium-and-adverse-outcomes-across-the-range-of-kidney-function-a-ckd-prognosis-consortium-meta-analysis
#12
Csaba P Kovesdy, Kunihiro Matsushita, Yingying Sang, Nigel J Brunskill, Juan J Carrero, Gabriel Chodick, Takeshi Hasegawa, Hiddo L Heerspink, Atsushi Hirayama, Gijs W D Landman, Adeera Levin, Dorothea Nitsch, David C Wheeler, Josef Coresh, Stein I Hallan, Varda Shalev, Morgan E Grams
Aims: Both hypo- and hyperkalaemia can have immediate deleterious physiological effects, and less is known about long-term risks. The objective was to determine the risks of all-cause mortality, cardiovascular mortality, and end-stage renal disease associated with potassium levels across the range of kidney function and evaluate for consistency across cohorts in a global consortium. Methods and results: We performed an individual-level data meta-analysis of 27 international cohorts [10 general population, 7 high cardiovascular risk, and 10 chronic kidney disease (CKD)] in the CKD Prognosis Consortium...
March 14, 2018: European Heart Journal
https://www.readbyqxmd.com/read/29548699/clinical-predictor-of-postoperative-hyperkalemia-after-parathyroidectomy-in-patients-with-hemodialysis
#13
Sijia Li, Shuangxin Liu, Qiuhuan Chen, Pingjiang Ge, Jie Jiang, Xiaoli Sheng, Shaohua Chen
OBJECTIVE: Hyperkalaemia is one of the most common reasons for patients requiring emergency treatment. This study is to investigate the risk factors of postoperative hyperkalemia in renal failure patients undergoing parathyroidectomy with autotransplantation (PTXa). METHODS: One hundred and eight patients [ 54 men and 54 women; age, 45.1 ± 11.1 years (mean ± SD)] with secondary hyperparathyroidism undergoing parathyroidectomy with autotransplantation were involved in this study...
May 2018: International Journal of Surgery
https://www.readbyqxmd.com/read/29545434/management-of-tumour-lysis-syndrome-during-first-line-palliative-chemotherapy-for-high-volume-colorectal-cancer
#14
Helena S Gouveia, Sílvia O Lopes, Ana Luísa Faria
Tumour lysis syndrome (TLS) is a rare oncological emergency in solid tumours. Because it is associated with bad short-term prognosis, early recognition and treatment are mandatory. This case refers to a middle-aged woman who presented with stage IV colon cancer, with massive hepatic involvement. After three cycles of first-line FOLFOX (folinic acid, 5-fluorouracil and oxaliplatin), she developed acute kidney injury and hyperkalaemia that did not respond to standard measures. High suspicion of TLS prompted further corroborating investigations and early intensive care unit admission...
March 15, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29496276/prevalence-and-incidence-of-hyperkalaemia-in-the-spanish-population-with-heart-failure-with-reduced-ejection-fraction-a-systematic-review-and-populational-relevance
#15
Á Hernáez, J F Delgado, J Cinca, F Fernández-Avilés, J Marrugat
BACKGROUND AND OBJECTIVES: Hyperkalaemia (K+ levels≥5.5mmol/L) is a severe ion imbalance that occurs in patients who have heart failure (HF) with reduced ejection fraction (HFrEF) and increases the risk of ventricular fibrillation. Given that there are no estimates on the number of patients with this complication, the aim of this study was to estimate the prevalence and incidence of hyperkalaemia in patients with HFrEF in Spain. MATERIAL AND METHODS: Based on a systematic literature search and through a meta-analysis, we calculated an HFrEF prevalence of ≤40% in the European and U...
February 26, 2018: Revista Clínica Española
https://www.readbyqxmd.com/read/29495340/dietary-approach-to-recurrent-or-chronic-hyperkalaemia-in-patients-with-decreased-kidney-function
#16
Adamasco Cupisti, Csaba P Kovesdy, Claudia D'Alessandro, Kamyar Kalantar-Zadeh
Whereas the adequate intake of potassium is relatively high in healthy adults, i.e., 4.7 g per day, a dietary potassium restriction of usually less than 3 g per day is recommended in the management of patients with reduced kidney function, especially those who tend to develop hyperkalaemia including patients who are treated with angiotensin pathway modulators. Most potassium-rich foods are considered heart-healthy nutrients with high fibre, high anti-oxidant vitamins and high alkali content such as fresh fruits and vegetables; hence, the main challenge of dietary potassium management is to maintain high fibre intake and a low net fixed-acid load, because constipation and metabolic acidosis are per se major risk factors for hyperkalaemia...
February 25, 2018: Nutrients
https://www.readbyqxmd.com/read/29493052/is-hyperkalaemia-in-heart-failure-a-risk-factor-or-a-risk-marker-implications-for-renin-angiotensin-aldosterone-system-inhibitor-use
#17
EDITORIAL
Lars H Lund, Bertram Pitt
No abstract text is available yet for this article.
May 2018: European Journal of Heart Failure
https://www.readbyqxmd.com/read/29438980/trimethoprim-use-for-urinary-tract-infection-and-risk-of-adverse-outcomes-in-older-patients-cohort-study
#18
Elizabeth Crellin, Kathryn E Mansfield, Clémence Leyrat, Dorothea Nitsch, Ian J Douglas, Adrian Root, Elizabeth Williamson, Liam Smeeth, Laurie A Tomlinson
OBJECTIVE: To determine if trimethoprim use for urinary tract infection (UTI) is associated with an increased risk of acute kidney injury, hyperkalaemia, or sudden death in the general population. DESIGN: Cohort study. SETTING: UK electronic primary care records from practices contributing to the Clinical Practice Research Datalink linked to the Hospital Episode Statistics database. PARTICIPANTS: Adults aged 65 and over with a prescription for trimethoprim, amoxicillin, cefalexin, ciprofloxacin, or nitrofurantoin prescribed up to three days after a primary care diagnosis of UTI between April 1997 and September 2015...
February 9, 2018: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/29397584/mineralocorticoid-receptor-antagonists-for-heart-failure-a-real-life-observational-study
#19
Noemi Bruno, Gianfranco Sinagra, Stefania Paolillo, Alice Bonomi, Ugo Corrà, Massimo Piepoli, Fabrizio Veglia, Elisabetta Salvioni, Rocco Lagioia, Marco Metra, Giuseppe Limongelli, Gaia Cattadori, Angela B Scardovi, Valentina Carubelli, Domenico Scrutino, Roberto Badagliacca, Marco Guazzi, Rosa Raimondo, Piero Gentile, Damiano Magrì, Michele Correale, Gianfranco Parati, Federica Re, Mariantonietta Cicoira, Maria Frigerio, Maurizio Bussotti, Carlo Vignati, Fabrizio Oliva, Alessandro Mezzani, Giuseppe Vergaro, Andrea Di Lenarda, Claudio Passino, Susanna Sciomer, Giuseppe Pacileo, Roberto Ricci, Mauro Contini, Anna Apostolo, Pietro Palermo, Massimo Mapelli, Cosimo Carriere, Francesco Clemenza, Simone Binno, Romualdo Belardinelli, Carlo Lombardi, Pasquale Perrone Filardi, Michele Emdin, Piergiuseppe Agostoni
AIMS: Mineralocorticoid receptor antagonists (MRAs) have been demonstrated to improve outcomes in reduced ejection fraction heart failure (HFrEF) patients. However, MRAs added to conventional treatment may lead to worsening of renal function and hyperkalaemia. We investigated, in a population-based analysis, the long-term effects of MRA treatment in HFrEF patients. METHODS AND RESULTS: We analysed data of 6046 patients included in the Metabolic Exercise Cardiac Kidney Index score dataset...
February 4, 2018: ESC Heart Failure
https://www.readbyqxmd.com/read/29381246/evidence-in-support-of-hyperkalaemia-management-strategies-a-systematic-literature-review
#20
REVIEW
Eirini Palaka, Saoirse Leonard, Amy Buchanan-Hughes, Anna Bobrowska, Bryony Langford, Susan Grandy
BACKGROUND: Hyperkalaemia is a potentially life-threatening condition that can be managed with pharmacological and non-pharmacological approaches. With the recent development of new hyperkalaemia treatments, new information on safe and effective management of hyperkalaemia has emerged. OBJECTIVES: This systematic literature review (SLR) aimed to identify all relevant comparative and non-comparative clinical data on management of hyperkalaemia in adults. Our secondary aim was to assess the feasibility of quantitatively comparing randomised controlled trial (RCT) data on the novel treatment sodium zirconium cyclosilicate (ZS) and established pharmacological treatments for the non-emergency management of hyperkalaemia, such as the cation-exchangers sodium/calcium polystyrene sulphonate (SPS/CPS)...
February 2018: International Journal of Clinical Practice
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