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Hyperkalemia hypokalemia

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https://www.readbyqxmd.com/read/29764543/-experimental-research-on-individual-specific-rapid-potassium-supplementation-strategy-for-fatal-severe-hypokalemia
#1
Yu Du, Yi Mou, Jin Liu
OBJECTIVE: To explore the effectiveness and safety of the individual-specific rapid potassium supplementation strategy, and to provide experimental basis for treating fatal severe hypokalemia. METHODS: An acute fatal severe hypokalemia model was reproduced in 20 healthy adult Japanese big ear white rabbits with half lethal dose (LD50) of barium chloride (BaCl2 ) solution 168 mg×5 mL-1 ×kg-1 . The rabbits were divided into conventional potassium supplementation group and individual-specific rapid potassium supplementation group according to random number table method with 10 rabbits in each group...
May 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29745804/protection-against-severe-hypokalemia-but-impaired-cardiac-repolarization-after-intense-rowing-exercise-in-healthy-humans-receiving-salbutamol
#2
Tania Atanasovska, Robert Smith, Claus Graff, Cao Thach Tran, Jacob Melgaard, Jørgen K Kanters, Aaron C Petersen, Antony Tobin, Keld P Kjeldsen, Michael John McKenna
Intense exercise induces pronounced hyperkalemia, followed by transient hypokalemia in recovery. We investigated whether the β2 -agonist salbutamol attenuated the exercise-hyperkalemia, and exacerbated the post-exercise hypokalemia, and whether hypokalemia was associated with impaired cardiac repolarization (QT hysteresis). Eleven healthy adults participated in a randomized, counterbalanced, double-blind trial receiving either 1000 µg salbutamol (SAL) or placebo (PLAC) by inhalation. Arterial plasma potassium concentration ([K+ ]a ) was measured at rest, during 3 min intense rowing exercise and 60 min recovery...
May 10, 2018: Journal of Applied Physiology
https://www.readbyqxmd.com/read/29686786/predictors-and-outcome-of-invasive-mechanical-ventilation-in-hospitalized-patients-with-sepsis-data-from-national-inpatient-sample
#3
Rashmi Dhital, Sijan Basnet, Dilli Ram Poudel
Background: Sepsis is a significant cause of mechanical ventilation in hospitalized patients. Objective: The aim of our study was to recognize the demographic and clinical characteristics associated with an increased need for invasive mechanical ventilation in hospitalized sepsis patients. Methods: We used National Inpatient Sample database from the years 2009-2011 to identify sepsis patients requiring invasive mechanical ventilation. We compared demographic and clinical characteristics of sepsis patients requiring and not requiring ventilator support and conducted univariate and multivariate analyses to determine odds ratio (OR) of association...
2018: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/29679302/association-of-abnormal-serum-potassium-levels-with-arrhythmias-and-cardiovascular-mortality-a-systematic-review-and-meta-analysis-of-observational-studies
#4
REVIEW
Liesa K Hoppe, Dana C Muhlack, Wolfgang Koenig, Prudence R Carr, Hermann Brenner, Ben Schöttker
PURPOSE: To provide the first systematic review and meta-analysis of observational studies on the association of abnormal serum potassium and cardiovascular outcomes. METHODS: Medline and ISI Web of Knowledge were systematically searched from inception until November 24, 2017. Data synthesis of relevant studies was performed using random effects model meta-analyses. RESULTS: Meta-analyses included 310,825 participants from 24 studies. In the older general population, low serum potassium was associated with a 1...
April 20, 2018: Cardiovascular Drugs and Therapy
https://www.readbyqxmd.com/read/29660779/clinical-findings-and-diagnostic-procedures-in-270-small-ruminants-with-obstructive-urolithiasis
#5
Anna-Katharina Riedi, Gabriela Knubben-Schweizer, Mireille Meylan
BACKGROUND: Details of the clinical signs of obstructive urolithiasis in male small ruminants have not been documented in a large population. OBJECTIVE: To describe the clinical presentation and diagnostic procedures in a large group of small ruminants with urolithiasis. ANIMALS: Two hundred and seventy small ruminants (158 sheep and 112 goats). METHODS: Retrospective study of 270 cases identified based on clinical records...
April 16, 2018: Journal of Veterinary Internal Medicine
https://www.readbyqxmd.com/read/29644055/pretreatment-of-enteral-nutrition-with-sodium-polystyrene-sulfonate-effective-but-beware-the-high-prevalence-of-electrolyte-derangements-in-clinical-practice
#6
Krisha Le Palma, Elisha Rampolla Pavlick, Lawrence Copelovitch
Background: Current treatment options for chronic hyperkalemia in children with chronic kidney disease include dietary restrictions or enteral sodium polystyrene sulfonate (SPS); however, dietary restrictions may compromise adequate nutrition and enteral SPS may be limited by palatability, adverse effects and feeding tube obstruction. A potentially safer alternative is to pretreat enteral nutrition (EN) with SPS prior to consumption. The purpose of this study was to evaluate the efficacy and safety of pretreating EN with SPS in pediatric patients with hyperkalemia...
April 2018: Clinical Kidney Journal
https://www.readbyqxmd.com/read/29572190/incident-hyperkalemia-hypokalemia-and-clinical-outcomes-during-spironolactone-treatment-of-heart-failure-with-preserved-ejection-fraction-analysis-of-the-topcat-trial
#7
Akshay S Desai, Jiankang Liu, Marc A Pfeffer, Brian Claggett, Jerome Fleg, Eldrin F Lewis, Sonja McKinlay, Eileen O'Meara, Sanjiv J Shah, Nancy K Sweitzer, Scott Solomon, Bertram Pitt
BACKGROUND: In patients with heart failure and preserved ejection fraction (HF-PEF) randomized in the Americas (but not Russia and Georgia) as part of the TOPCAT trial, treatment with spironolactone enhanced the risk of hyperkalemia but reduced the risk of hypokalemia. We examined the clinical correlates and prognostic implications of incident hypo- and hyperkalemia during study follow up. METHODS: We defined the region-specific incidence of hypokalemia (potassium [K+ ]<3...
March 20, 2018: Journal of Cardiac Failure
https://www.readbyqxmd.com/read/29472808/pseudohyperkalemia-potassium-released-from-cells-due-to-clotting-and-centrifugation-a-case-report
#8
REVIEW
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
https://www.readbyqxmd.com/read/29357785/safety-efficacy-and-timeliness-of-intravenous-potassium-chloride-replacement-protocols-in-a-pediatric-cardiothoracic-intensive-care-unit
#9
Rambod Amirnovin, Phuong Lieu, Flerida Imperial-Perez, Carol Taketomo, Barry P Markovitz, David Y Moromisato
OBJECTIVE: Hypokalemia in children following cardiac surgery occurs frequently, placing them at risk of life-threatening arrhythmias. However, renal insufficiency after cardiopulmonary bypass warrants careful administration of potassium (K+ ). Two different nurse-driven protocols (high dose and tiered dosing) were implemented to identify an optimal K+ replacement regimen, compared to an historical low-dose protocol. Our objective was to evaluate the safety, efficacy, and timeliness of these protocols...
January 1, 2018: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29322723/thyrotoxic-channelopathies
#10
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/29310400/clinical-analysis-of-hyperkalemia-after-esophagectomy-a-case-report
#11
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/29278563/recognizing-thyrotoxic-hypokalemic-periodic-paralysis
#12
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/29218312/potassium-homeostasis-oxidative-stress-and-human-disease
#13
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/29203252/occurrence-and-improvement-of-renal-dysfunction-and-serum-potassium-abnormality-during-administration-of-liposomal-amphotericin-b-in-patients-with-hematological-disorders-a-retrospective-analysis
#14
Hiroyuki Yamazaki, Tadakazu Kondo, Kazunai Aoki, Kouhei Yamashita, Akifumi Takaori-Kondo
Liposomal amphotericin B (L-AMB) has the potential to cause two major adverse events, renal dysfunction and serum potassium abnormality; however, appropriate clinical management of these events remains unclear. We retrospectively analyzed data regarding 128 hematology patients who received L-AMB in our institute and examined the association between clinical characteristics and renal dysfunction or serum potassium abnormality. We found that the median weight-normalized dose of L-AMB was 2.69mg/kg and the median administration period was 16days...
February 2018: Diagnostic Microbiology and Infectious Disease
https://www.readbyqxmd.com/read/29135624/potassium-chloride-sustained-release-dosing-pathway-in-an-academic-medical-center
#15
Bryan M Cook, Danielle M Carter, Heather Dell'Orfano, Lina Matta
Potassium supplementation can be administered intravenously or orally with either immediate release or sustained release formulations. Sustained release potassium chloride allows for delayed absorption and peak effects. In the inpatient setting, it is important to monitor and prevent both hypokalemia and hyperkalemia. Our tertiary-care academic hospital created a clinical pathway for sustained release potassium chloride supplementation in the inpatient population. Our clinical pathway for sustained release potassium chloride creates dosing restrictions designed to prevent hyperkalemia, while allowing exceptions for patients with high requirements...
December 2017: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/29080909/association-between-hypo-and-hyperkalemia-and-outcome-in-acute-heart-failure-patients-the-role-of-medications
#16
Matthieu Legrand, Pierre-Olivier Ludes, Ziad Massy, Patrick Rossignol, Jiri Parenica, Jin-Joo Park, Shiro Ishihara, Khalid F AlHabib, Aldo Maggioni, Òscar Miró, Naoki Sato, Alain Cohen-Solal, Enrique Fairman, Johan Lassus, Veli-Pekka Harjola, Christian Mueller, Franck W Peacock, Dong-Ju Choi, Patrick Plaisance, Jindřich Spinar, Mikhail Kosiborod, Alexandre Mebazaa, Etienne Gayat
BACKGROUND: The interaction between chronic medications on admission and the association between serum potassium level and outcome in patients with acute heart failure (AHF) are unknown. METHODS: Observational intercontinental study of patients admitted with AHF. 15954 patients were included from 12 cohorts in 4 continents. Main outcome was 90-day mortality. Clinical presentation (medication use, hemodynamics, comorbidities), demographic, echocardiographic, and biochemical data on admission were recorded prospectively in each cohort, with prospective adjudication of outcomes...
March 2018: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/29031359/treatment-of-abnormalities-of-potassium-homeostasis-in-ckd
#17
REVIEW
Biff F Palmer, Deborah J Clegg
Hyperkalemia, defined as serum potassium concentrations greater than 5.0 to 5.5 mEq/L, is a frequent occurrence in clinical practice because of the increasing incidence and prevalence of CKD. Patients at risk for this disorder are commonly treated with drugs that interfere in the renin-angiotensin-aldosterone system, thereby enhancing the occurrence and prevalence of this disorder. Discontinuation of these drugs because of the development of hyperkalemia deprives these patients the renal-protective and cardiovascular benefits this class of pharmacology has been shown to provide...
September 2017: Advances in Chronic Kidney Disease
https://www.readbyqxmd.com/read/29031358/hyperkalemia-and-hypokalemia-in-ckd-prevalence-risk-factors-and-clinical-outcomes
#18
REVIEW
Sarah Gilligan, Kalani L Raphael
Abnormalities of serum potassium are common in patients with CKD. Although hyperkalemia is a well-recognized complication of CKD, the prevalence rates of hyperkalemia (14%-20%) and hypokalemia (12%-18%) are similar. CKD severity, use of medications such as renin-angiotensin-aldosterone system inhibitors and diuretics, and dietary potassium intake are major determinants of serum potassium concentration in CKD. Demographic factors, acid-base status, blood glucose, and other comorbidities contribute as well. Both hyperkalemia and hypokalemia are associated with similarly increased risks of death, cardiovascular disease, and hospitalization...
September 2017: Advances in Chronic Kidney Disease
https://www.readbyqxmd.com/read/29031357/regulation-of-potassium-homeostasis-in-ckd
#19
REVIEW
Thomas D DuBose
Disturbances of potassium homeostasis can cause either hyperkalemia or hypokalemia and result in serious consequences. Although the consequences of acute and chronic hyperkalemia and treatment of these conditions in CKD have been widely appreciated by nephrologists, more recent information has focused attention on the consequences of chronic hypokalemia. Several recent studies have documented a "U-shaped" relationship between the serum [K+ ] and higher mortality in several clinical studies. The causes of dyskalemias are placed into the unique perspective of patients with CKD and its evolution with progression of CKD to later stages and focuses on the pathophysiology of these disorders...
September 2017: Advances in Chronic Kidney Disease
https://www.readbyqxmd.com/read/29025765/long-term-potassium-monitoring-and-dynamics-in-heart-failure-and-risk-of-mortality
#20
Julio Núñez, Antoni Bayés-Genís, Faiez Zannad, Patrick Rossignol, Eduardo Núñez, Vicent Bodí, Gema Miñana, Enrique Santas, Francisco J Chorro, Anna Mollar, Arturo Carratalá, Jorge Navarro, Jose Luis Górriz, Josep Lupón, Oliver Husser, Marco Metra, Juan Sanchis
BACKGROUND: The prognostic value of long-term potassium monitoring and dynamics in heart failure has not been characterized completely. We sought to determine the association between serum potassium values collected at follow-up with all-cause mortality in a prospective and consecutive cohort of patients discharged from a previous acute heart failure admission. METHODS: Serum potassium was measured at every physician-patient encounter, including hospital admissions and ambulatory settings...
March 27, 2018: Circulation
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