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treatment of hyperkalemia

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https://www.readbyqxmd.com/read/27917793/high-dose-oral-furosemide-with-salt-ingestion-in-the-treatment-of-refractory-ascites-of-liver-cirrhosis
#1
Tolga Yakar, Mehmet Demir, Ozlem Dogan, Alper Parlakgumus, Birol Ozer, Ender Serin
PURPOSE: We aimed to evaluate and compare the efficacy and safety of high-dose furosemide+salt orally by comparing HSS+ furosemide (i.v.) and repeated paracentesis in patients with RA. METHODS: This was a prospective study of 78 cirrhotic patients with RA, randomized into three groups: Group A (n= 25) i.v. furosemide (200-300 mg bid) and 3% hypotonic saline solution (HSS) (once or twice a day); Group B (n= 26) oral furosemide tablets (360-520 mg bid) and salt (2...
December 1, 2016: Clinical and Investigative Medicine. Médecine Clinique et Experimentale
https://www.readbyqxmd.com/read/27915044/a-novel-aldosterone-synthase-inhibitor-ameliorates-mortality-in-pressure-overload-mice-with-heart-failure
#2
Shinji Furuzono, Masaki Meguro, Satoru Miyauchi, Shinichi Inoue, Tsuyoshi Homma, Keisuke Yamada, Yoh-Ichi Tagawa, Futoshi Nara, Takahiro Nagayama
It has been elucidated that mineralocorticoid receptor antagonists reduce mortality in patients with congestive heart failure and post-acute myocardial infarction. A direct inhibition of aldosterone synthase (CYP11B2) is also expected to have therapeutic benefits equal in quality to mineralocorticoid receptor antagonists in terms of reducing mineralocorticoid receptor signaling. Therefore, we have screened our chemical libraries and identified a novel and potent aldosterone synthase inhibitor, 2,2,2-trifluoro-1-{4-[(4-fluorophenyl)amino]pyrimidin-5-y}-1-[1-(methylsulfonyl)piperidin-4-yl]ethanol (compound 1), by lead optimization...
November 30, 2016: European Journal of Pharmacology
https://www.readbyqxmd.com/read/27891040/inadvertent-injection-of-potassium-chloride-instead-of-sodium-chloride-during-treatment-of-chronic-low-back-ache-with-epidural-injection-leading-to-paraplegia
#3
Rahul Ranjan, Naiyer Asif, Sohail Ahmad, Syed Ifthekar
Epidural injection of steroid is given for back pain resistant to other conservative management. Normal saline (NS) is used as diluent in 80 mg methylprednisolone and a local anesthetic. Due to a similar looking ampoule of NS and potassium chloride (KCl), there is a probability of accidental use of KCl instead of NS. We present a case of a 50-year-old male patient having low back ache refractory to other conservative treatments. Epidural injection of steroid was given, but accidently KCl was mixed with methylprednisolone instead of NS...
October 2016: Journal of Craniovertebral Junction and Spine
https://www.readbyqxmd.com/read/27884576/extracorporeal-life-support-for-refractory-cardiac-arrest-from-accidental-hypothermia-a-10-year-experience-in-edinburgh
#4
Maziar Khorsandi, Scott Dougherty, Neil Young, Dean Kerslake, Vincenzo Giordano, Robert Lendrum, William Walker, Vipin Zamvar, Ivan Yim, Renzo Pessotto
BACKGROUND: Cardiac arrest caused by accidental hypothermia is a rare phenomenon with a significant mortality rate if untreated. The consensus is that these patients should be rewarmed with extracorporeal life support (ECLS) with the potential for excellent survival and neurologic outcomes. However, given the lack of robust data and clinical trials, the optimal management of such patients remains elusive. OBJECTIVE: In this single-center study, we looked at the outcomes of all adult patients undergoing salvage ECLS for cardiac arrest caused by accidental hypothermia over a 10-year period from June 2006 to June 2016...
November 21, 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27863290/cardiorenal-acute-kidney-injury-epidemiology-presentation-causes-pathophysiology-and-treatment
#5
REVIEW
Luca Di Lullo, Antonio Bellasi, Domenico Russo, Mario Cozzolino, Claudio Ronco
Cardiovascular disease and major cardiovascular events represent main cause of death in both acute and chronic kidney disease patients. Kidney and heart failure are common and frequently co-exist; this organ - organ interaction, also called organ cross-talk led to well-known definition of cardiorenal syndrome (CRS). Here we'll describe cardiovascular involvement in patients with acute kidney injury (AKI). Also known as type-3 CRS or acute reno-cardiac CRS, it occurs when AKI contributes and/or precipitates development of acute cardiac injury...
November 9, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27857927/a-fatal-adverse-effect-of-barbiturate-coma-therapy-dyskalemia
#6
Hyun Mook Kwon, Jin Wook Baek, Sang Pyung Lee, Jae Ik Cho
The management guideline for traumatic brain injury (TBI) recommends high-dose barbiturate therapy to control increased intracranial pressure refractory to other therapeutic options. High-dose barbiturate therapy, however, may cause many severe side effects; the commonly recognized ones include hypotension, immunosuppression, hepatic dysfunction, renal dysfunction, and prolonged decrease of cortical activity. Meanwhile, dyskalemia remains relatively uncommon. In this study, we report the case of a hypokalemic patient with severe rebound hyperkalemia, which occurred as a result of barbiturate coma therapy administered for TBI treatment...
October 2016: Korean Journal of Neurotrauma
https://www.readbyqxmd.com/read/27850870/1234-impact-of-dextrose-dose-on-hypoglycemia-development-following-treatment-of-hyperkalemia
#7
Nicholas Farina, Christopher Anderson
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27843645/safety-and-antihypertensive-effect-of-selara%C3%A2-eplerenone-results-from-a-postmarketing-surveillance-in-japan
#8
Shoko Takahashi, Megumi Hiramatsu, Shinichi Hotta, Yukie Watanabe, Osamu Suga, Yutaka Endo, Isamu Miyamori
Prospective postmarketing surveillance of Selara (eplerenone), a selective mineralocorticoid receptor antagonist, was performed to confirm its safety and efficacy for hypertension treatment in Japan. The change in blood pressure after initiation of eplerenone treatment was also examined. Patients with essential hypertension who were eplerenone-naïve were recruited regardless of the use of other antihypertensive drugs. For examination of changes in blood pressure, patients were excluded if eplerenone was contraindicated or used off-label...
2016: International Journal of Hypertension
https://www.readbyqxmd.com/read/27784004/patiromer-decreases-serum-potassium-and-phosphate-levels-in-patients-on-hemodialysis
#9
David A Bushinsky, Patrick Rossignol, David M Spiegel, Wade W Benton, Jinwei Yuan, Geoffrey A Block, Christopher S Wilcox, Rajiv Agarwal
BACKGROUND: Persistent hyperkalemia (serum potassium (K) ≥5.5 mEq/l) is a common condition in hemodialysis (HD) patients, is associated with increased mortality, and treatment options are limited. The effect of patiromer, a gastrointestinal K binder, on serum K was examined in HD patients. METHODS: Six hyperkalemic HD patients (5 anuric) were admitted to clinical research units for 15 days (1 pretreatment week and 1 patiromer treatment week) and they received a controlled diet with identical meals on corresponding days of pretreatment and treatment weeks...
2016: American Journal of Nephrology
https://www.readbyqxmd.com/read/27780982/a-patient-with-pseudohypoaldosteronism-type-ii-complicated-by-congenital-hypopituitarism-carrying-a-klhl3-mutation
#10
Marie Mitani, Munehiro Furuichi, Satoshi Narumi, Tomonobu Hasegawa, Motoko Chiga, Shinichi Uchida, Seiji Sato
Pseudohypoaldosteronism type II (PHA II) is a renal tubular disease that causes hyperkalemia, hypertension, and metabolic acidosis. Mutations in four genes (WNK4, WNK1, KLHL3, and CUL3) are known to cause PHA II. We report a patient with PHA II carrying a KLHL3 mutation, who also had congenital hypopituitarism. The patient, a 3-yr-old boy, experienced loss of consciousness at age 10 mo. He exhibited growth failure, hypertension, hyperkalemia, and metabolic acidosis. We diagnosed him as having PHA II because he had low plasma renin activity with normal plasma aldosterone level and a low transtubular potassium gradient...
October 2016: Clinical Pediatric Endocrinology: Case Reports and Clinical Investigations: Official Journal of the Japanese Society for Pediatric Endocrinology
https://www.readbyqxmd.com/read/27775507/evidence-based-management-of-potassium-disorders-in-the-emergency-department
#11
John Ashurst, Shane R Sergent, Benjamin R Sergent
Hypokalemia and hyperkalemia are the most common electrolyte disorders managed in the emergency department. The diagnosis of these potentially life-threatening disorders is challenging due to the often vague symptomatology a patient may express, and treatment options may be based upon very little data due to the time it may take for laboratory values to return. This review examines the most current evidence with regard to the pathophysiology, diagnosis, and management of potassium disorders. In this review, classic paradigms, such as the use of sodium polystyrene and the routine measurement of serum magnesium, are tested, and an algorithm for the treatment of potassium disorders is discussed...
November 2016: Emergency Medicine Practice
https://www.readbyqxmd.com/read/27754188/sp-05-1-should-the-target-for-blood-pressure-reduction-be-lower-in-adults-with-hypertension-and-a-history-of-cardiovascular-disease
#12
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
https://www.readbyqxmd.com/read/27754081/os-19-04-chronic-diuretic-therapy-does-not-impair-the-effectiveness-of-patiromer-in-hyperkalemic-patients-with-ckd
#13
Matthew Weir, Martha Mayo, Dahlia Garza, Susan Arthur, Lance Berman, David Bushinsky, Daniel Wilson, Murray Epstein
OBJECTIVE: Diuretics, alone or in combination, are frequently prescribed in chronic kidney disease (CKD) and heart failure (HF) patients to reduce volume, blood pressure, and/or for symptom control. Clinicians may also use them to reduce the risk of hyperkalemia, but high doses of diuretics may lead to adverse events from intravascular volume depletion or gout. Patiromer is a non-absorbed K-binding polymer recently approved by the FDA for the treatment of hyperkalemia (HK). We compared patiromer's effects in RAASi-treated CKD patients with HK on different types of diuretics to patients not receiving diuretics in the treatment phase of OPAL-HK...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27754080/os-19-03-treatment-with-patiromer-resulted-in-decreases-in-aldosterone-in-patients-with-chronic-kidney-disease-and-hyperkalemia-on-raas-inhibitors-results-from-opal-hk
#14
Matthew Weir, George L Bakris, Coleman Gross, Martha R Mayo, Dahlia Garza, Jinwei Yuan, Lance Berman, Gordon H Williams
OBJECTIVE: Elevated serum aldosterone can be vasculotoxic and facilitates cardiorenal damage. Renin-angiotensin-aldosterone inhibitors (RAASi) reduce serum aldosterone levels and/or block its effects but can cause hyperkalemia (HK). Patiromer, a nonabsorbed potassium binder, decreases serum potassium (K) in CKD patients on RAASi. We examined the effect of patiromer on serum aldosterone levels, plasma renin activity (PRA), systolic (SBP) and diastolic blood pressure (DBP), and urinary albumin-to-creatinine ratio (UACR) in CKD patients on RAASi with HK (serum K 5...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27747728/colchicine-induced-acute-neuromyopathy-in-a-patient-using-concomitant-fluconazole-case-report-and-literature-review
#15
Yi-Chia Su, Chih-Chien Wu
A 54-year-old woman presented at the emergency department after experiencing lower limb weakness and bilateral ankle pain for 2 days. She had a history of type 2 diabetes mellitus, diabetes mellitus nephropathy with chronic kidney disease, and chronic gouty arthritis. She had received 0.6 mg colchicine orally once or twice daily for 8 months. Four days prior to her emergency department visit, she was discharged from our nephrology ward, where she had been admitted because of a urinary tract infection. During hospitalization, she was treated with intravenous cefazolin for 7 days...
December 2015: Drug Safety—Case Reports
https://www.readbyqxmd.com/read/27746291/limited-efficacy-of-tolvaptan-in-patients-with-cirrhosis-and-severe-hyponatremia-real-life-experience
#16
Elisa Pose, Elsa Solà, Salvatore Piano, Elisabetta Gola, Isabel Graupera, Mónica Guevara, Andrés Cárdenas, Paolo Angeli, Pere Ginès
BACKGROUND: Vaptans, vasopressin selective V2-receptor antagonist, represent the first pharmacological approach to the treatment of hypervolemic hyponatremia in cirrhosis. However, information on the use of vaptans for patients with cirrhosis and hyponatremia in a real-life scenario is very limited. Therefore, this study evaluated the effect of tolvaptan on serum sodium in patients with cirrhosis and severe hypervolemic hyponatremia. METHODS: Nine patients with cirrhosis and serum sodium <125mEq/L were included...
October 13, 2016: American Journal of Medicine
https://www.readbyqxmd.com/read/27725623/acute-and-chronic-cardiovascular-effects-of-hyperkalemia-new-insights-into-prevention-and-clinical-management
#17
Sandeep K Krishnan, Norman E Lepor
Hyperkalemia is a common electrolyte disorder associated with life-threatening cardiac arrhythmias and increased mortality. Patients at greatest risk for hyperkalemia include those with diabetes and those with impaired renal function in whom a defect in the excretion of renal potassium may already exist. Hyperkalemia is likely to become more common clinically because angiotensin receptor blockers and angiotensin-converting enzyme inhibitors are increasingly being used in higher doses and are thought to confer cardiovascular and renal protection...
2016: Reviews in Cardiovascular Medicine
https://www.readbyqxmd.com/read/27704256/achieving-remission-of-proteinuria-in-childhood-ckd
#18
Piero Ruggenenti, Paolo Cravedi, Antonietta Chianca, MariaRosa Caruso, Giuseppe Remuzzi
BACKGROUND: A multidrug treatment strategy that targets urinary proteins with an angiotensin-converting enzyme (ACE) inhibitor and angiotensin receptor blocker (ARB) up-titrated to the respective maximum tolerated dose combined with intensified blood pressure (BP) control has been found to prevent renal function loss in adults with proteinuric nephropathies. Herein, we investigated the effects of this treatment protocol in the pediatric patient population. METHODS: From May 2002 to September 2014 we included in this observational, longitudinal, cohort study 20 consecutive children with chronic nephropathies and 24-h proteinuria of >200 mg who had received ramipril and losartan up-titrated to the respective maximum approved and tolerated doses [mean (standard deviation) dose:2...
October 4, 2016: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/27693804/emergency-management-of-severe-hyperkalemia-guideline-for-best-practice-and-opportunities-for-the-future
#19
Patrick Rossignol, Matthieu Legrand, Mikhail Kosiborod, Steven M Hollenberg, W Frank Peacock, Michael Emmett, Murray Epstein, Csaba P Kovesdy, Mehmet Birhan Yilmaz, Wendy Gattis Stough, Etienne Gayat, Bertram Pitt, Faiez Zannad, Alexandre Mebazaa
Hyperkalemia is a common electrolyte disorder, especially in chronic kidney disease, diabetes mellitus, or heart failure. Hyperkalemia can lead to potentially fatal cardiac dysrhythmias, and it is associated with increased mortality. Determining whether emergency therapy is warranted is largely based on subjective clinical judgment. The Investigator Network Initiative Cardiovascular and Renal Clinical Trialists (INI-CRCT) aimed to evaluate the current knowledge pertaining to the emergency treatment of hyperkalemia...
September 29, 2016: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
https://www.readbyqxmd.com/read/27691951/bilateral-hydronephrosis-in-a-sugar-glider-petaurus-breviceps
#20
Lara Cusack, Rodney Schnellbacher, Elizabeth W Howerth, David A Jiménez, Joerg Mayer, Stephen Divers
An adult, intact male sugar glider ( Petaurus breviceps ) presented for acute caudal abdominal swelling. Treatment by the referring veterinarian included aspiration of urine from the swelling. On physical examination, mild depression, pale mucus membranes, and caudal abdominal swelling were noted. Focused ultrasonographic assessment revealed a fluid-filled caudal abdominal structure and subjective bladder wall thickening. The following day, the sugar glider was severely depressed. Hematology results included hypoglycemia, hyperkalemia, hyponatremia, and azotemia...
September 2016: Journal of Zoo and Wildlife Medicine: Official Publication of the American Association of Zoo Veterinarians
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