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https://www.readbyqxmd.com/read/29152151/aliskiren-for-heart-failure-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#1
Hongzhi Liu, Hongxing Luo, Suqin Wang, Cong Zhang, Jialiang Hao, Chuanyu Gao
Objective: To systematically review and synthesize the currently available evidence of aliskiren for the treatment of heart failure. Materials and Methods: We systematically searched the Cochrane, Embase and PubMed databases to identify the randomized controlled trials (RCT) on the effects of aliskiren on heart failure. Data were synthesized with random effects model and presented in forest plot. Publication bias was evaluated with funnel plot. Heterogeneity was evaluated with Begg's test and Egger's test...
October 20, 2017: Oncotarget
https://www.readbyqxmd.com/read/29127125/vancomycin-resistant-enterococcus-faecium-bacteraemia-as-a-complication-of-kayexalate-sodium-polystyrene-sulfonate-sps-in-sorbitol-induced-ischaemic-colitis
#2
Roberto Christian Cerrud-Rodriguez, Diego Alcaraz-Alvarez, Brian Bobby Chiong, Abdurhman Ahmed
We present the case report of an 80-year-old woman with chronic kidney disease stage G5 admitted to the hospital with fluid overload and hyperkalaemia. Sodium polystyrene sulfonate (SPS, Kayexalate) in sorbitol suspension was given orally to treat her hyperkalaemia, which precipitated an episode of SPS in sorbitol-induced ischaemic colitis with the subsequent complication of vancomycin-resistant Enterococcus (VRE) bacteraemia. SPS (Kayexalate) in sorbitol suspension has been implicated in the development of intestinal necrosis...
November 9, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29121282/effects-of-intraoperative-and-early-postoperative-normal-saline-or-plasma-lyte-148%C3%A2-on-hyperkalaemia-in-deceased-donor-renal-transplantation-a-double-blind-randomized-trial
#3
L Weinberg, L Harris, R Bellomo, F L Ierino, D Story, G Eastwood, M Collins, L Churilov, P F Mount
Background: Administration of saline in renal transplantation is associated with hyperchloraemic metabolic acidosis, but the effect of normal saline (NS) on the risk of hyperkalaemia or postoperative graft function is uncertain. Methods: We compared NS with Plasma-Lyte 148® (PL) given during surgery and for 48 h after surgery in patients undergoing deceased donor renal transplantation. The primary outcome was hyperkalaemia within 48 h after surgery. Secondary outcomes were need for hyperkalaemia treatment, change in acid-base status, and graft function...
October 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29106612/mediterranean-diet-as-the-diet-of-choice-for-patients-with-chronic-kidney-disease
#4
Philippe Chauveau, Michel Aparicio, Vincenzo Bellizzi, Katrina Campbell, Xu Hong, Lina Johansson, Anne Kolko, Pablo Molina, Siren Sezer, Christoph Wanner, Pieter M Ter Wee, Daniel Teta, Denis Fouque, Juan J Carrero
Traditional dietary management of chronic kidney disease (CKD) focuses on the quantity within the diet of energy and protein, and the restriction of single micronutrients, with little mention of dietary quality. Dietary patterns that are more plant-based, lower in meat (including processed meat), sodium and refined sugar, and have a higher content of grains and fibres are now included in multiple clinical guidelines for chronic disease prevention. The Mediterranean diet (MD) has been associated with reduced cardiovascular disease incidence in both observational and interventional studies...
July 2, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/29098731/clues-for-early-detection-of-autoimmune-addison-s-disease-myths-and-realities
#5
Å B Saevik, A-K Åkerman, K Grønning, I Nermoen, S F Valland, T E Finnes, M Isaksson, P Dahlqvist, R Bergthorsdottir, O Ekwall, J Skov, B G Nedrebø, A-L Hulting, J Wahlberg, J Svartberg, C Höybye, I H Bleskestad, A P Jørgensen, O Kämpe, M Øksnes, S Bensing, E S Husebye
BACKGROUND: Early detection of autoimmune Addison's disease (AAD) is important as delay in diagnosis may result in a life-threatening adrenal crisis and death. The classical clinical picture of untreated AAD is well-described, but methodical investigations are scarce. OBJECTIVE: Perform a retrospective audit of patient records with the aim of identifying biochemical markers for early diagnosis of AAD. MATERIAL AND METHODS: A multicentre retrospective study including 272 patients diagnosed with AAD at hospitals in Norway and Sweden during 1978-2016...
November 3, 2017: Journal of Internal Medicine
https://www.readbyqxmd.com/read/29038191/obstructive-uropathy-as-initial-presentation-of-genitourinary-tuberculosis-and-masquerading-as-a-postsurgical-complication
#6
Grace Igiraneza, Theobald Hategekimana, Olivier M Manzi, Onyema Ogbuagu
A 46-year-old woman who had a recent total abdominal hysterectomy presented with a 1 month history of lower abdominal pain, 1 week of nausea and vomiting as well as decreased urinary output preceded by a year of significant unintentional weight loss. On renal imaging, she was found to have bilateral hydronephrosis and hydroureters in the setting of bilateral distal ureteric obstruction complicated with acute kidney injury and severe hyperkalaemia requiring haemodialysis. The initial concern was for ureteric injury, a known complication of abdominal hysterectomy procedures, however, a urological intervention, performed 9 months later to relieve the ureteric obstruction, revealed purulent material within the left ureter that was smear positive for acid fast bacilli...
October 15, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28940684/the-cold-hard-facts-seasonal-variation-in-outcomes-after-kidney-transplantation
#7
Wai H Lim, Germaine Wong
Seasonal variation in the incidence and cardiovascular disease complications in the general population has been well documented (1) . According to analysis of data from the United States Renal Data System (USRDS) of all prevalent end-stage kidney disease (ESKD) patients between 2000 and 2013, the transition to ESKD (i.e. initiation of renal replacement therapy) and the incidence of all-cause and cause-specific mortality in patients with ESKD were highest during winter months (particularly January) compared to summer months, suggesting the possibility of season-specific precipitants during winter months contributing to adverse outcomes in both the general population and in patients with ESKD (2) ...
September 22, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28894410/life-threatening-dyskalaemia-after-barbiturate-coma-therapy-the-strategy-of-management
#8
Yeap Boon Tat, Wan Mohd Nazaruddin Wan Hassan, Ting Yung Chuen, Abdul Rahman Izaini Ghani
Barbiturate coma therapy (BCT) is a treatment option that is used for refractory intracranial hypertension after all other options have been exhausted. Although BCT is a brain protection treatment, it also has several side effects such as hypotension, hepatic dysfunction, renal dysfunction, respiratory complications and electrolyte imbalances. One less concerning but potentially life-threatening complication of BCT is dyskalaemia. This complication could present as severe refractory hypokalaemia during the therapy with subsequent rebound hyperkalaemia after cessation of the therapy...
March 2017: Malaysian Journal of Medical Sciences: MJMS
https://www.readbyqxmd.com/read/28872780/impaired-renal-function-affects-clinical-outcomes-and-management-of-patients-with-heart-failure
#9
Rebeka Jenkins, Lilly Mandarano, Saraniga Gugathas, Juan Carlos Kaski, Lisa Anderson, Debasish Banerjee
AIMS: Inpatients with heart failure and renal impairment have poor outcomes and variable quality of care. We investigate treatment practice and outcomes in an unselected real-world cohort using historical creatinine measurements. METHODS AND RESULTS: Admissions between 1/4/2013 and 30/4/2015 diagnosed at discharge with heart failure were retrospectively analysed. Stages of chronic kidney disease (CKD) and acute kidney injury (AKI) were calculated from creatinine at discharge and 3-12 months before admission...
September 5, 2017: ESC Heart Failure
https://www.readbyqxmd.com/read/28847139/swimming-three-ice-miles-within-fifteen-hours
#10
Mirko Stjepanovic, Pantelis T. Nikolaidis, Beat Knechtle
Ice Mile swimming (1608 m in water of below 5 °Celsius) is becoming increasingly popular. This case study aimed to identify body core temperature and selected haematological and biochemical parameters before and after repeated Ice Miles. An experienced ice swimmer completed three consecutive Ice Miles within 15 h. Swim times, body core temperatures, and selected urinary and haematological parameters were recorded. Body core temperature reached its maximum between 5, 8 and 15 min after immersion (37.7°C, 38...
August 31, 2017: Chinese Journal of Physiology
https://www.readbyqxmd.com/read/28844155/effects-of-aliskiren-on-mortality-cardiovascular-outcomes-and-adverse-events-in-patients-with-diabetes-and-cardiovascular-disease-or-risk-a-systematic-review-and-meta-analysis-of-13-395-patients
#11
Sean L Zheng, Alistair J Roddick, Salma Ayis
BACKGROUND: Aliskiren was shown to increase adverse events in patients with diabetes and concomitant renin-angiotensin blockade. We aim to investigate the efficacy and safety of aliskiren in patients with diabetes and increased cardiovascular risk or established cardiovascular disease. METHODS: MEDLINE and Embase were searched for prospective studies comparing addition of aliskiren to standard medical therapy in patients with diabetes and cardiovascular disease, or ⩾1 additional cardiovascular risk factor (hypertension, abnormal lipid profile, microalbuminuria/proteinuria, chronic kidney disease)...
September 2017: Diabetes & Vascular Disease Research
https://www.readbyqxmd.com/read/28797478/heat-stress-is-associated-with-disruption-of-ion-balance-in-the-migratory-locust-locusta-migratoria
#12
James D B O'Sullivan, Heath A MacMillan, Johannes Overgaard
Thermal tolerance is important in determining the spatial and temporal distributions of insects but the mechanisms which determine upper thermal limits remain poorly understood. In terrestrial insects heat tolerance is unlikely to be limited by oxygen supply but in some arthropods, heat stress has been shown to cause haemolymph hyperkalaemia which is known to have detrimental effects on neuromuscular excitability. It is however unresolved if heat-induced hyperkalemia is the cause or the result of cellular heat injury...
August 2017: Journal of Thermal Biology
https://www.readbyqxmd.com/read/28782299/continuous-erythropoiesis-receptor-activator-cera-for-the-anaemia-of-chronic-kidney-disease
#13
REVIEW
Valeria M Saglimbene, Suetonia C Palmer, Marinella Ruospo, Patrizia Natale, Jonathan C Craig, Giovanni Fm Strippoli
BACKGROUND: Continuous erythropoiesis receptor activator (CERA) is a newer, longer acting ESA which might be preferred to other ESAs (epoetin or darbepoetin) based on its lower frequency of administration. Different dosing requirements and molecular characteristics of CERA compared with other ESAs may lead to different health outcomes (mortality, cardiovascular events, quality of life) in people with anaemia and chronic kidney disease (CKD). OBJECTIVES: To assess benefits and harms of CERA compared with other epoetins (darbepoetin alfa and epoetin alfa or beta) or placebo/no treatment or CERA with differing strategy of administration for anaemia in individuals with CKD...
August 7, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28751628/aliskiren-therapy-in-hypertension-and-cardiovascular-disease-a-systematic-review-and-a-meta-analysis
#14
REVIEW
Shufang Fu, Xin Wen, Fei Han, Yin Long, Gaosi Xu
The efficacy and safety of aliskiren combination therapy with angiotensin converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs) in patients with hypertension and cardiovascular disease remains attractive attention. We searched the Cochrane Central Register, the Clinical Trials Registry, EMBASE, MEDLINE and PubMed for relevant literatures up to January 2017. A total of 13 randomized controlled trials (RCTs) with 12222 patients were included in this study, and the combined results indicated that aliskiren in combination therapy with ACEIs or ARBs had remarkable effects in reducing systolic blood pressure (SBP) [weighted mean differences (WMD), -4...
July 19, 2017: Oncotarget
https://www.readbyqxmd.com/read/28751432/severe-hypokalaemia-as-a-cause-of-acute-transient-quadriparesis
#15
Martin Bell Lybecker, Henrik Bjørnsgaard Madsen, Jens Meldgaard Bruun
Hypokalaemic paralysis covers a heterogeneous group of disorders caused either by an enhanced shift of potassium into the cells or following a significant renal or gastrointestinal loss of potassium. We present the case of a 48-year-old Caucasian man with paralysis of both upper and lower extremities. ECG showed sinus rhythm and characteristic changes of hypokalaemia with depression of the ST segment, prolonged QTc interval of 581ms and U waves seen as a small positive deflection at the T wave in the middle precordial leads...
July 27, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28749067/haemolysis-in-haemodialysis
#16
REVIEW
Dhakshayini Tharmaraj, Peter G Kerr
Haemolysis in haemodialysis, although rare in current times, is associated with significant mortality and morbidity. As such prompt recognition, treatment, analysis of root cause and correction of underlying causative factors is crucial. Dialysate, extracorporeal circuit and patient related factors all contribute to haemolysis risk. Haemolysis can manifest with non-specific signs and symptoms including but not restricted to hypertension, nausea, pain (abdominal, chest, back) and dyspnoea. It may present acutely during the dialysis session or may take a protracted course...
July 27, 2017: Nephrology
https://www.readbyqxmd.com/read/28729329/fluids-in-sepsis-and-septic-shock-fissh-protocol-for-a-pilot-randomised-controlled-trial
#17
Bram Rochwerg, Tina Millen, Peggy Austin, Michelle Zeller, Frédérick D'Aragon, Roman Jaeschke, Marie-Hélène Masse, Sangeeta Mehta, Francois Lamontagne, Maureen Meade, Gordon Guyatt, Deborah J Cook
INTRODUCTION: Observational evidence suggests physiological benefits and lower mortality with lower chloride solutions; however, 0.9% saline remains the most widely used fluid worldwide. Given uncertainty regarding the association of lower chloride on mortality, it is unlikely that practice will change without direct randomised clinical trial (RCT) evidence. This pilot RCT will investigate the feasibility of a large-scale trial directly comparing low chloride with high chloride fluids in patients with septic shock...
July 20, 2017: BMJ Open
https://www.readbyqxmd.com/read/28710236/complement-factor-b-mutation-associated-ahus-and-myocardial-infarction
#18
Natália Noronha, Filipa Dias Costa, Andrea Dias, Alexandra Dinis
A 6-month-old female infant was referred with a 3-day history of low-grade fever, slight nasal congestion and rhinorrhoea. On admission, the clinical findings were unremarkable and she was discharged home. However, she became progressively more listless with a decreased urine output and was once again seen in the emergency department. Analytically she was found to have metabolic acidosis, hyperkalaemia, thrombocytopaenia, anaemia and schistocytes in the peripheral blood smear. Based on these findings, the diagnosis of haemolyticâ-uremic syndrome was made...
July 14, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28689048/the-impact-of-hypothermia-on-serum-potassium-concentration-a-systematic-review
#19
REVIEW
Sarah Buse, Marc Blancher, Damien Viglino, Mathieu Pasquier, Maxime Maignan, Pierre Bouzat, Thorsten Annecke, Guillaume Debaty
BACKGROUND: Blood potassium is the main prognostic biomarker used for triage in hypothermic cardiac arrest. The aim of this review was to assess the impact of hypothermia on blood potassium levels and compare the underlying pathophysiological theories. METHODS: The Medline electronic database was searched via PubMed for articles published from January 1970 to December 2016. The search strategy included studies related to hypothermia and potassium levels. The relevant literature on clinical studies and experimental studies was reviewed by the authors...
September 2017: Resuscitation
https://www.readbyqxmd.com/read/28662543/the-impact-of-serum-potassium-influencing-antihypertensive-drugs-on-the-risk-of-out-of-hospital-cardiac-arrest-a-case-control-study
#20
Fawaz F Alharbi, Patrick C Souverein, Mark C H de Groot, Marieke T Blom, Anthonius de Boer, Olaf H Klungel, Hanno L Tan
AIMS: Sudden cardiac arrest (SCA) is a complex multifactorial event and most commonly caused by ventricular tachycardia/ fibrillation (VT/ VF). Some antihypertensive drugs could induce hypokalaemia or hyperkalaemia, which may increase susceptibility to VT/VF and SCA. OBJECTIVE: To assess the association between different classes of antihypertensive drugs classified according to their potential impact on serum potassium levels and the occurrence of out-of-hospital cardiac arrest (OHCA) based on VT/VF...
November 2017: British Journal of Clinical Pharmacology
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