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guidelines hypokalemia

Vernon Min Sen Oh
According to the Singapore National Health Survey (NHS) of 2010, the population of the Republic of Singapore was 5.076,700, comprising four ethnic groups: Chinese (74.1%), Malays (13.4%), Indians (9.2%), and others (3.3%). The National Health Survey for 2016 is under way and due to be published in 2017. From the six-yearly national health surveys, the crude prevalence of clinical hypertension (HTn), defined as a sustained blood pressure ≥ 140/90 mmHg, in Singaporean residents aged 30 to 69 years rose from 22...
September 2016: Journal of Hypertension
Gian Paolo Rossi
Primary aldosteronism (PA) involves more than 11% of patients referred to specialized hypertension centers and, therefore, is much more common than commonly held. Moreover, it causes a damage to the heart, blood vessels and kidneys, which translates into a high rate of cardiovascular events, in excess to the degree of blood pressure raise. Along with the notion that a timely diagnosis entails a fundamental step for the choice of an appropriate therapy, which can correct the arterial hypertension and the hypokalemia, this justifies efforts to search for PA in the majority of the patients with hypertension...
September 2016: Journal of Hypertension
Paul Whelton
BACKGROUND: Choice of the optimal target for blood pressure (BP) reduction during treatment of patients with hypertension, including those with underlying co-morbid conditions, is an important challenge in clinical practice. The Systolic Blood Pressure Intervention Trial (SPRINT) was designed to provide guidance in selection of a Systolic BP target during treatment of hypertension. METHODS: Adults ≥50 years old with hypertension and at least one additional risk factor for cardiovascular disease (CVD), but excluding persons with diabetes mellitus, prior stroke, or advanced chronic kidney disease (CKD) were randomly assigned to intensive therapy (intensive), targeting a systolic BP (SBP) <120 mmHg, or standard therapy (standard), targeting a SBP <140 mmHg...
September 2016: Journal of Hypertension
Lin Shi
According to the seventh report of Joint National Committee (JNC 7), hypertensive emergency (HE), a kind of hypertensive crisis, is defined as a sudden and abrupt elevation in blood pressure so as to cause acute target organ dysfunctions, including central nervous system, cardiovascular system or kidneys. Patients with HE require immediate reduction in markedly elevated blood pressure. Currently, there are no international guidelines for children HE, so the JNC definition is commonly used. Hypertensive emergency in children is rare but a life-threatening emergency...
September 2016: Journal of Hypertension
Robert M Carey
Primary aldosteronism with a prevalence of 8 % of hypertension and 20 % of pharmacologically resistant hypertension is the most common secondary cause of hypertension. Yet, the diagnosis is missed in the vast majority of patients. Current clinical practice guidelines recommend screening for primary aldosteronism in patients with sustained elevation of blood pressure (BP) ≥150/100 mmHg if possible prior to initiation of antihypertensive therapy, and in patients with resistant hypertension, spontaneous or diuretic-induced hypokalemia, adrenal incidentaloma, obstructive sleep apnea, a family history of early onset of hypertension or cerebrovascular accident <age 40, and first-degree relatives of patients with primary aldosteronism...
October 2016: Current Cardiology Reports
Gretchen Yandle, Derek J Vonderhaar, Theepha Thayalakulasingam, Arthur Zieske, David Smith, Lee S Engel, Robert Richards, Fred A Lopez
Primary aldosteronism PA is a secondary cause of hypertension that is often missed due to inadequate clinical evaluation and the lack of classically described laboratory abnormalities. Based on guidelines from the Endocrine Society, primary aldosteronism should be suspected in young patients with moderate to severe hypertension, patients with hypertension and coexisting hypokalemia, any patient with hypertension and an incidental adrenal adenoma, and hypertension in the setting of a significant family history of early onset hypertension or cerebral vascular accident in a first degree relative less than 40 years of age...
January 2016: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
Dimitrios Velissaris, Vassilios Karamouzos, Charalampos Pierrakos, Ioanna Koniari, Christina Apostolopoulou, Menelaos Karanikolas
The aim of the review was to summarize the literature over the last 25 years regarding bicarbonate administration in out-of-hospital cardiac arrest. A PubMed search was conducted using the terms "bicarbonates" and "cardiac arrest", limited to human studies and reviews published in English (or at least with a meaningful abstract in English) in the last 25 years. Clinical and experimental data raised questions regarding the safety and effectiveness of sodium bicarbonate (SB) administration during cardiac arrest...
April 2016: Journal of Clinical Medicine Research
Bertha Wong, Amy Cheng, Catherine Yu, Jeannette Goguen
OBJECTIVES: Hypokalemia, a frequently cited complication of diabetic ketoacidosis (DKA) treatment, can have critical implications, including arrhythmias and death. We assessed the prevalence of hypokalemia and its associated factors in patients with DKA at our tertiary-care centre and identified opportunities to improve care. METHODS: We conducted a retrospective chart review to establish the prevalence of hypokalemia in patients diagnosed with DKA between July 2012 and July 2013...
June 2016: Canadian Journal of Diabetes
Line Malha, Samuel J Mann
Loop diuretics are not recommended in current hypertension guidelines largely due to the lack of outcome data. Nevertheless, they have been shown to lower blood pressure and to offer potential advantages over thiazide-type diuretics. Torsemide offers advantages of longer duration of action and once daily dosing (vs. furosemide and bumetanide) and more reliable bioavailability (vs. furosemide). Studies show that the previously employed high doses of thiazide-type diuretics lower BP more than furosemide. Loop diuretics appear to have a preferable side effect profile (less hyponatremia, hypokalemia, and possibly less glucose intolerance)...
April 2016: Current Hypertension Reports
John W Funder, Robert M Carey, Franco Mantero, M Hassan Murad, Martin Reincke, Hirotaka Shibata, Michael Stowasser, William F Young
OBJECTIVE: To develop clinical practice guidelines for the management of patients with primary aldosteronism. PARTICIPANTS: The Task Force included a chair, selected by the Clinical Guidelines Subcommittee of the Endocrine Society, six additional experts, a methodologist, and a medical writer. The guideline was cosponsored by American Heart Association, American Association of Endocrine Surgeons, European Society of Endocrinology, European Society of Hypertension, International Association of Endocrine Surgeons, International Society of Endocrinology, International Society of Hypertension, Japan Endocrine Society, and The Japanese Society of Hypertension...
May 2016: Journal of Clinical Endocrinology and Metabolism
Philip S Mehler, Kristine Walsh
OBJECTIVE: Eating disorders that are associated with purging behaviors are complicated by frequent blood electrolyte and acid-base abnormalities. Herein, we review the major electrolyte and acid-base abnormalities and their treatment methods. The body of rigorous, eating disorder-specific literature on this topical area is not robust enough to perform a systematic review as defined by PRISMA guidelines. Therefore, a qualitative review of mostly medical literature was conducted. RESULTS: Hypokalemia, hyponatremia, and sodium chloride-responsive metabolic alkalosis are the most common serum changes that occur as a result of purging behaviors...
March 2016: International Journal of Eating Disorders
Taís Daiene Russo Hortencio, Roberto José Negrao Nogueira, Fernando Augusto de Lima Marson, Antonio Fernando Ribeiro
BACKGROUND: Hypophosphatemia, hypomagnesemia, and hypokalemia occur in patients receiving parenteral nutrition (PN), mainly when the body's stores are depleted due to fasting or inflammation. Although these disorders are potentially fatal, few studies have reported the incidence in the pediatric population. METHODS: This study evaluated, in a historical cohort of pediatric patients, the prevalence of hypophosphatemia, hypokalemia, and hypomagnesaemia until 48 hours before initiation of PN infusion (P1) and from days 1-4 (P2) and days 5-7 (P3) of PN infusion and investigated if malnutrition, calories, and protein infusion were correlated to these disorders...
April 2016: Nutrition in Clinical Practice
Amanda E Hagan, Crystal A Farrington, Geoffrey C Wall, Mark M Belz
BACKGROUND: Hyperkalemia is a common problem in hospitalized patients, especially those with underlying chronic kidney disease, but evidence-based guidelines for its treatment are lacking. Sodium polystyrene sulfonate (SPS), a cation exchange resin first approved by the FDA for the treatment of hyperkalemia in 1958, is frequently used alone or in conjunction with other medical therapies to lower serum potassium. Recently, the safety and efficacy of SPS have come into question based on multiple reported cases of bowel necrosis associated with SPS administration...
January 2016: Clinical Nephrology
Lindsay E Kuo, Heather Wachtel, Robert E Roses, Douglas L Fraker, Rachel R Kelz
BACKGROUND: Primary hyperaldosteronism is a common cause of hypertension, with significant cardiovascular, renal, and metabolic sequelae. Delayed diagnosis of primary hyperaldosteronism can lead to severe disease and lower cure rates after adrenalectomy. This study investigated the presentation and outcomes of patients who had primary hyperaldosteronism diagnosed after incidental discovery of an adrenal mass. METHODS: A retrospective cohort study investigated patients receiving adrenalectomy for primary hyperaldosteronism at the authors' institution from 2001 to 2014...
December 2015: Annals of Surgical Oncology
Pervaiz M Zunga, Omar Farooq, Mohd I Dar, Ishrat H Dar, Samia Rashid, Abdul Q Rather, Javid A Basu, Mohammed Ashraf, Jahangeer A Bhat
The osmotic demyelination syndrome (ODS) has been identified as a complication of the rapid correction of hyponatremia for decades. However, in recent years, a variety of other medical conditions have been associated with the development of ODS, independent of changes in serum sodium which cause a rapid changes in osmolality of the interstitial (extracellular) compartment of the brain leading to dehydration of energy-depleted cells with subsequent axonal damage that occurs in characteristic areas. Slow correction of the serum sodium concentration and additional administration of corticosteroids seems to be a major prevention step in ODS patients...
January 2015: Annals of Neurosciences
P Kümpers
The nonphysiological high chloride content of 0.9 % saline causes hyperchloremic acidosis and rapidly reduces renal perfusion in healthy volunteers-negative affects not seen with balanced crystalloids with low chloride content. Evidence from recently published studies strongly suggests that 0.9 % saline negatively effects outcome in surgical and critically ill patients. Major complications are the increased incidence of acute kidney injury and need for renal replacement therapy, as well as higher postoperative in-hospital mortality...
July 2015: Der Internist
Matthew R Weir, Ramon Espaillat
Hypokalemia is a common electrolyte disturbance, observed in > 20% of hospitalized patients. Hypokalemia, although not formally defined, is generally considered to be when serum potassium levels fall below the normal value of 3.6 mmol/L. In contrast to other electrolytes, potassium is primarily an intracellular ion: only 2% of all potassium in the body is present in the extracellular fluid, so a small decrease in serum potassium may represent a significant decrease in intracellular potassium. Individuals with mildly decreased potassium levels (3...
June 2015: Postgraduate Medicine
Sadiya S Khan, Umberto Campia, Ovidiu Chioncel, Faiez Zannad, Patrick Rossignol, Aldo P Maggioni, Karl Swedberg, Marvin A Konstam, Michele Senni, Savina Nodari, Muthiah Vaduganathan, Haris Subacius, Javed Butler, Mihai Gheorghiade
Both hyperkalemia and hypokalemia may be related to heart failure (HF) therapy and are associated with adverse outcomes. Abnormalities in serum potassium levels in hospitalized patients with HF and reduced ejection fraction (EF) have not been previously investigated. A post hoc analysis was performed in 1,907 hospitalized patients with worsening HF and reduced EF in the placebo arm of the Efficacy of Vasopressin Antagonism in HF Outcome Study with Tolvaptan (EVEREST) trial. Serum potassium was measured at randomization and at discharge or day 7...
March 15, 2015: American Journal of Cardiology
Pablo Olmos, Aníbal Donoso, Juan Pablo Arab, Ian Niklitschek, Nicolás Mertens, Elizabeth Arce, Rosario Lemus, Valentina Serrano, Bruno Grassi, Kristel Strodthoff, Eduardo Abbott, Andrés Aizman, María Verónica González
BACKGROUND: During 2009, new guidelines for the treatment of diabetic ketoacidosis were published by the American Diabetes Association. AIM: To assess the impact of new treatment guidelines on the evolution of patients treated for diabetic ketoacidosis (KAD). PATIENTS AND METHODS: Anonymous data was obtained from computational medical records of patients treated for KAD at our institution two years before ("Traditional Protocol") and TWO years after ("ADA-2009 Protocol") the publication of the 2009 American Diabetes Association (ADA) KAD guidelines...
October 2014: Revista Médica de Chile
Debasish Ghosh, Kenneth M Williams, Garry G Graham, Priya Nair, Hergen Buscher, Richard O Day
INTRODUCTION: Aspirin overdose, though now infrequently encountered, nevertheless continues to contribute to significant morbidity and mortality. The patient described in this case report intentionally ingested overdoses of aspirin on repeated occasions. The case provided an unusual and possibly one-of-a-kind opportunity to focus on the variability in the time course of plasma salicylate concentrations with current treatment modalities of aspirin overdose in an individual patient. CASE PRESENTATION: A 75-year-old Caucasian man who weighed 45 kg and had an extensive history of various drug overdoses and stage 3 chronic kidney disease presented to a tertiary university hospital on three occasions within 2 months after successive overdoses of aspirin...
2014: Journal of Medical Case Reports
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