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Treatment hyperkaliemia

Khawla Kammoun, Hanen Chaker, Hichem Mahfoudh, Nouha Makhlouf, Faical Jarraya, Jamil Hachicha
BACKGROUND: Mediterranean diet is characterized by low to moderate consumption of animal protein and high consumption of fruits, vegetables, bread, beans, nuts, seeds and other cereals. It has been associated with reduced risk of cardiovascular disease. However, it is not suitable for chronic kidney disease because of high potassium intake. DISCUSSION: Tunisia is an emerging Mediterranean country with limited resources, a high prevalence of chronic hemodialysis treatment and high dialysis expenditures...
January 23, 2017: BMC Nephrology
Omar Bjanid, Piotr Adamczyk, Małgorzata Stojewska, Dagmara Roszkowska-Bjanid, Magdalena Paszyna-Grześkowiak, Agnieszka Jędzura, Joanna Oświęcimska, Katarzyna Ziora, Aurelia Morawiec-Knysak, Maria Szczepańska
A 14-year-old Caucasian girl with a history of primary hypoparathyroidism and unstable calcium and phosphorus levels and on ongoing treatment was admitted to the Department of Pediatric Nephrology because of the onset of nephrocalcinosis and difficulties achieving normocalcemia. Coexistence of hypoparathyroidism, oral candidiasis, dental enamel hypoplasia, and subclinical Hashimoto's disease was strongly suggestive for autoimmune polyglandular syndrome (APS) type I. One of the clinical implications of this diagnosis is the high probability of future occurrence of adrenal insufficiency and hence the importance of maintaining a high level of suspicion in case of the onset of symptoms like weakness, fainting, hypotonia, or hyperkaliemia...
April 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Mohammed Asserraji, Ibrahim Benameur, Omar Maoujoud, Abdennasser El Kharras, Hicham Hajbi, Karim Filali
BACKGROUND: Exertional heat stroke (EHS) is still a main cause of death in sport. Many of EHS complications could have been prevented if EHS had been recognized and treated early and properly. CASE PRESENTATION: We report an unusual case of multiple organ failure caused by EHS due to intensive sportive activities in a hot environment with lack of primary care. A 35-year-old healthy sportive man was admitted in our hospital because of muscle aches and weakness as well as dark urine three days after a six hour marathon run (Agadir Semi-Marathon) in a very sunny day...
June 2014: Asian Journal of Sports Medicine
David van Dellen, Afshin Tavakoli, Richard Wadsworth, Titus Augustine
OBJECTIVES: Live donation has become increasingly valuable as a potential source of kidneys for transplant with hand-assisted laparoscopic donation is an important method of organ procurement. An important consideration is adequate preoperative and intraoperative planning, and precautions to minimize potential risks in the donor while providing a graft with good primary function. MATERIALS AND METHODS: We present a case of live donation in which a hand-assisted laparoscopic approach was used to facilitate kidney donation...
December 2011: Experimental and Clinical Transplantation
V Wenzel, S G Russo, H R Arntz, J Bahr, M A Baubin, B W Böttiger, B Dirks, U Kreimeier, M Fries, C Eich
ADULTS: Administer chest compressions (minimum 100/min, minimum 5 cm depth) at a ratio of 30:2 with ventilation (tidal volume 500-600 ml, inspiration time 1 s, F(I)O₂ if possible 1.0). Avoid any interruptions in chest compressions. After every single defibrillation attempt (initially biphasic 120-200 J, monophasic 360 J, subsequently with the respective highest energy), chest compressions are initiated again immediately for 2 min independent of the ECG rhythm. Tracheal intubation is the optimal method for securing the airway during resuscitation but should be performed only by experienced airway management providers...
December 2010: Der Anaesthesist
Olivera Potrebić, Jasmina Jović-Stosić, Slavica Vucinić, Jelena Tadić, Misel Radulac
INTRODUCTION: Clinical picture of severe glyphosate-surfactant poisoning is manifested by gastroenteritis, respiratory disturbances, altered mental status, hypotension refractory to the treatment, renal failure, shock. Single case report indicated possible neurotoxic sequels of glyphosate-surfactant exposure with white matter lesions and development of Parkinsonism. We described a patient with massive white matter damage which led to vigil coma and lethal outcome. CASE REPORT: A 56-year old woman ingested about 500 mL of herbicide containing glyphosate isopropylamine salt...
September 2009: Vojnosanitetski Pregled. Military-medical and Pharmaceutical Review
N Engrand, S Demeret, D Savary, B Clair
The systemic consequences of status epilepticus occur in two stages: the first stage is a hyperadrenergic period (high blood pressure, tachycardia, arrhythmia, hyperventilation, hypermetabolism, hyperthermia), the second stage a collapsus period, sometimes with acute circulatory failure, and hypoxemia. Symptomatic resuscitation aimed at restoring vital functions should be undertaken. Resuscitation must be started immediately before hospital transfer, by a trained emergency team. Respiratory care includes at least oxygen intake, but it can also require oral intubation (crash induction) and mechanical ventilation...
April 2009: Revue Neurologique
H Kassem, C Hajjar, T El Gharbi, L Turner
We report a 53-year-old woman with hyperkaliemia secondary to treatment with atenolol. The diagnosis of atenolol induced hyperkaliemia was obtained after excluding other causes of hyperkaliemia and normalization of potassium serum level following the discontinuation of this medication without any other modification (treatment or diet). Furthermore, when atenolol was again introduced, serum potassium level increased and normalized when atenol was definitively discontinued. The mechanism of hyperkaliemia we suspected is probably a reduction of potassium intracellular transfer...
August 2009: La Revue de Médecine Interne
L Abdennour, L Puybasset
Sedation-analgesia occupies an essential place in the specific therapeutic arsenal of the brain-injured patients. The maintenance of the perfusion of the brain, its relaxation and its protection are the fundamental objectives whose finality is to avoid the extension of the lesions and to preserve the neuronal capital. Sedation is instituted when patients are severely agitated or present a deterioration of their state of consciousness (GCS< or =8). Under cover of mechanical ventilation, sedation is the first line treatment of intracranial hypertension, a common pathway of various acute brain diseases of traumatic, vascular or other origin...
July 2008: Annales Françaises D'anesthèsie et de Rèanimation
Joanna Konopa, Barbara Bullo, Bolesław Rutkowski
Patients with congestive heart failure are at increased risk of hyperkalemia due to coexisting morbidities and usage of multiple medications that impair potassium excretion--such as angiotensin-converting enzyme inhibitors or spironolactone. Because of the risk of this disturbance, knowledge of causation and prevention is mandatory. We described 3 patients with life threatening hyperkalemia (>8.5 mEq/t) caused by drugs. We showed the symptoms of increased potassium level, the list of medications and comorbidities predisposing to hyperkalemia...
March 2006: Polskie Archiwum Medycyny Wewnętrznej
Sara M Viganò, Salvatore Di Filippo, Celestina Manzoni, Francesco Locatelli
The most appropriate dialysate composition is one of the central topics in dialysis treatment. The prescription of a certain dialysate composition could change in order to obtain not only an adequate blood purification but also a high tolerability. Sodium balance represents the cornerstone of cardiovascular stability and good blood pressure control. The goal of dialysis is to remove the amount that has accumulated in the interdialysis period. Potassium removal is adequate when hyperkaliemia is avoided. Bicarbonate in dialysate should be personalized in order to avoid acidosis and end-dialysis excessive alkalosis...
2008: Contributions to Nephrology
A A Skvortsov, V Yu Mareev, S M Chelmakina, N A Baklanova, Iu N Belenkov
Aim of the investigation was the study of influence of spironolactone (25 - 75 mg/day) on clinico-functional status, parameters of left ventricular (LV) remodeling, as well as safety of its long term application in patients with chronic heart failure (CHF) receiving optimal therapy. Forty nine patients were included in the study - 44 men (89,8%) and 5 women (10,2%) in the age from 28 to 75 years with II-IV NYHA functional class (FC) CHF, LV ejection fraction (EF) 35%, plasma levels of creatinine 150 mmol/L and potassium 5 mmol/L...
2007: Kardiologiia
Enrique Galve
Antialdosteronic treatment is used again in heart failure. It pursues the neurohormonal blockage of the final effector of the renin-angiotensin axis. Employed agents include espironolactone and, more recently, eplerenone (which lacks the adverse effects of the former such as gynecomastia). They have beneficial effects both in advanced heart failure (NYHA class III or IV) and heart insufficiency appearing after myocardial infarction. It remains to be demonstrated if they are also effective in less advanced chronic heart insufficiency (NYHA class II) and diastolic cardiac failure, though several ongoing studies are testing this benefit...
January 19, 2008: Medicina Clínica
Vitalinda Pumo, Dorotea Sciacca, Mariano Malaguarnera
The majority of cancers occur in adults over the age of 65, with about 70% of all cancer deaths in this population. Tumor lysis syndrome (TLS) is a complication of hematological and others malignancies, caused by massive tumor cell lysis due to chemotherapy, immunotherapy, radiotherapy. TLS can determine an alteration of the body's normal homeostatic mechanisms and cause hyperuricemia, hyperkaliemia, hyperphosphatemia, hypocalcaemia and uremia. Aggressive fluid administration has been recommended in all patients presumed to be at risk of this syndrome...
October 2007: Critical Reviews in Oncology/hematology
Nikolina Basić-Jukić, Ivana Jurić, Petar Kes, Ljubica Bubić-Filipi, Bruna Brunetta, Josip Pasini
Arterial hypertension develops in up to 80% of renal transplant recipients. Uncontrolled hypertension induces left ventricular hypertrophy, heart failure and death, but also promotes deterioration of allograft function. Cadaveric transplantation, delayed graft function, renal artery stenosis, presence of native kidneys, increased body weight and therapy with calcineurin inhibitors and steroids have been associated with an increased incidence of hypertension after kidney transplantation. Cyclosporine increases both systemic and renal vascular resistance, enhances sympathetic activation, endothelin production and, possibly, decreases vascular relaxation by decreasing the generation of nitric oxide...
April 2007: Acta Medica Croatica: C̆asopis Hravatske Akademije Medicinskih Znanosti
Z Fumeaux
Hyperkalemia is a frequently met electrolytic disorder in clinical practice. Blood potassium concentration is primarily under the control of cellular transfer, driven either by the acid basic equilibrium, the action of catecholamines and insulin, and secondarily by the kidney. In the majority of cases, hyperkaliemia is due to renal failure, together with the effect of drugs. The clinical symptoms, particularly cardiac manifestations, of hyperkaliemia can be serious, and this is why the identification of its cause and its treatment are of the utmost importance...
March 7, 2007: Revue Médicale Suisse
J M López Alvarez, M E Valerón Lemaur, E Consuegra Llapur, L Urquía Martí, A Morón Saén de Casas, R González Jorge
Three cases of children admitted to the Pediatric Intensive Medicine Unit in the months of February to March 2004 with the diagnosis of streptococcal toxic shock syndrome are presented. Two were under 2 years of age and the initial symptoms suggested viriasis. They evolved towards septic shock with early multiorganic failure and then death due to massive hemoptysis, ventricular fibrillation due to hyperkaliemia. Streptococcus pyogenes with serotypes M1T1 was isolated in all the cases and the patients had the clinical criteria of streptococcal toxic shock syndrome...
March 2007: Medicina Intensiva
Neil Chapman, Joanna Dobson, Sarah Wilson, Björn Dahlöf, Peter S Sever, Hans Wedel, Neil R Poulter
Spironolactone is recommended as fourth-line therapy for essential hypertension despite few supporting data for this indication. We evaluated the effect among 1411 participants in the Anglo-Scandinavian Cardiac Outcomes Trial-Blood Pressure Lowering Arm who received spironolactone mainly as a fourth-line antihypertensive agent for uncontrolled blood pressure and who had valid BP measurements before and during spironolactone treatment. Among those who received spironolactone, the mean age was 63 years (SD: +/-8 years), 77% were men, and 40% had diabetes...
April 2007: Hypertension
V Wenzel, S Russo, H R Arntz, J Bahr, M A Baubin, B W Böttiger, B Dirks, V Dörges, C Eich, M Fischer, B Wolcke, S Schwab, W G Voelckel, H W Gervais
The new CPR guidelines are based on a scientific consensus which was reached by 281 international experts. Chest compressions (100/min, 4-5 cm deep) should be performed in a ratio of 30:2 with ventilation (tidal volume 500 ml, Ti 1 s, FIO2 if possible 1.0). After a single defibrillation attempt (initially biphasic 150-200 J, monophasic 360 J, subsequently with the respective highest energy), chest compressions are initiated again immediately for 2 min. Endotracheal intubation is the gold standard; other airway devices may be employed as well depending on individual skills...
September 2006: Der Anaesthesist
Macroui A Sonikian, Ioanna T Pani, Anastasios N Iliopoulos, Kaliopi G Koutala, Stamatia I Marioli, Dimosthenis A Vlassopoulos
Reports on acid-base side effects of sevelamer hydrochloride (SH), a new aluminum (Al)- and calcium (Ca)-free phosphate binder are rare and conflicting. In a retrospective analysis, we evaluated SH impact on metabolic acidosis and serum potassium (K) in hemodialysis (HD) patients. Two groups of stable HD patients were studied. Group A included 17 patients, M/F=15/2, 64 (42-80) years old, dialyzed since 130 (34-253) months, under SH for 24 months. Group B serving as controls was made of 7 patients, M/F=4/3, 67 (48-91) years old, dialyzed since 67 (27-174) months, under CaCO3 and/or Al(OH)3 as phosphate binders also for 24 months...
2005: Renal Failure
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