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treatment of hyperkalemia

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https://www.readbyqxmd.com/read/28222034/three-cases-of-gordon-syndrome-with-dominant-klhl3-mutations
#1
Ji Soo Park, Eujin Park, Hye Sun Hyun, Yo Han Ahn, Hee Gyung Kang, Il-Soo Ha, Hae Il Cheong
BACKGROUND: Gordon syndrome (GS) is a rare form of monogenic hypertension characterized by low renin hypertension, hyperkalemia, hyperchloremic metabolic acidosis, and normal glomerular filtration rate. To date, four genes causing GS have been identified as: WNK1, WNK4, CUL3, and KLHL3. CASE REPORT: We report three cases of GS in two families. All patients presented with typical clinical features of GS and had a known dominant KLHL3 mutation. Oral thiazide treatment with low salt diet resulted in normalization of blood pressure and serum electrolytes in all three cases...
February 21, 2017: Journal of Pediatric Endocrinology & Metabolism: JPEM
https://www.readbyqxmd.com/read/28212180/advances-in-the-management-of-hyperkalemia-in-chronic-kidney-disease
#2
Andrea C J Cowan, Elie G Gharib, Matthew A Weir
PURPOSE OF REVIEW: Patients with chronic kidney disease (CKD) have an increased risk of hyperkalemia that increases both short-term and long-term mortality. Historically, managing hyperkalemia has relied upon dietary modifications, augmentation of urinary potassium excretion and enhanced enteral potassium elimination. This review discusses current treatments and their limitations and summarizes the evidence supporting novel agents for potassium lowering in patients with CKD. RECENT FINDINGS: The introduction of two novel ion exchange resins represents the first new pharmacologic therapies for hyperkalemia in the last 50 years...
February 15, 2017: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/28203093/prevention-and-treatment-of-tumor-lysis-syndrome-and-the-efficacy-and-role-of-rasburicase
#3
REVIEW
Nael Alakel, Jan Moritz Middeke, Johannes Schetelig, Martin Bornhäuser
Tumor lysis syndrome (TLS) is a potentially life-threatening condition that occurs in oncologic and hematologic patients with large tumor burden, either due to cytotoxic therapy or, less commonly, spontaneously because of massive tumor cell lysis. TLS is clinically characterized by acute renal failure, hyperuricemia, hyperkalemia, hyperphosphatemia, and hypocalcemia. While limited options are available for treating TLS, identifying patients at high risk for developing TLS and prevention in high-risk patients remain an important aspect in the treatment of cancer patients...
2017: OncoTargets and Therapy
https://www.readbyqxmd.com/read/28192629/the-effect-of-co-trimoxazole-on-serum-potassium-concentration-safety-evaluation-of-a-randomised-controlled-trial
#4
Wei Yee Chan, Allan B Clark, Andrew M Wilson, Yoon K Loke
AIMS: Co-trimoxazole maintains a well-established role in the treatment of Pneumocystis jirovecii and Toxoplasma gondii, as well as urinary tract infections. Observational studies report hyperkalemia associated with co-trimoxazole which may stem from an amiloride-like potassium sparing effect. Our study reports on changes in serum potassium on patients without acute infections, and the influence of concomitant anti-kaliuretic drugs on this effect. METHODS: Post-hoc analysis of a randomised controlled trial in patients with interstitial lung disease who were assigned to placebo or 960 mg twice daily co-trimoxazole...
February 13, 2017: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28166084/unexpected-complication-of-cocaine-associated-anti-neutrophil-cytoplasmic-antibody-vasculitis-related-to-persistent-in-hospital-cocaine-use
#5
Travis D Olives, Rebecca L Kornas, Russell Fujisawa, Jon B Cole
INTRODUCTION: Levamisole-adulterated cocaine has been implicated in anti-neutrophil cytoplasmic antibody (ANCA) vasculitis. We present a case of spontaneous intraperitoneal hemorrhage, an unexpectedly severe complication of cocaine-related ANCA vasculitis, developing late during hospitalization. CASE REPORT: An adult male with a history of hepatitis C, distant cocaine use, and limited health care presented to a local emergency department (ED) with volume overload, renal failure, hyperkalemia and non-anion gap metabolic acidosis...
February 3, 2017: Journal of Addiction Medicine
https://www.readbyqxmd.com/read/28149085/complications-in-mechanically-ventilated-patients-of-guillain-barre-syndrome-and-their-prognostic-value
#6
Archana Becket Netto, Arun B Taly, Girish B Kulkarni, G S Uma Maheshwara Rao, Shivaji Rao
INTRODUCTION: The spectrum of various complications in critically ill Guillain-Barre syndrome (GBS) and its effect on the prognosis is lacking in literature. This study aimed at enumerating the complications in such a cohort and their significance in the prognosis and mortality. MATERIALS AND METHODS: Retrospective case record analysis of all consecutive mechanically ventilated patients of GBS in neurology Intensive Care Unit (ICU) of a tertiary care institute for 10 years was done...
January 2017: Journal of Neurosciences in Rural Practice
https://www.readbyqxmd.com/read/28144092/metabolic-toxicities-in-patients-undergoing-treatment-for-nonhematological-malignancy-a-cross-sectional-study
#7
Subhash Gupta, Kunhi Parambath Haresh, Soumyajit Roy, Lakhan Kashyap, Narayan Adhikari, Rambha Pandey, Dayanand Sharma, Pramod Kumar Julka, Goura Kishor Rath
OBJECTIVES: The objective of this study was to evaluate the prevalence of metabolic toxicities in patients with different nonhematological malignancies admitted in oncology ward of a tertiary cancer care center while on treatment. METHODS: We did this cross-sectional study over a period of 7 months (January-July 2013) for all adult patients (n = 280) who, while undergoing anti-cancer therapy at our center, got admitted to our oncology inpatient ward with metabolic toxicity...
October 2016: Indian Journal of Medical and Paediatric Oncology
https://www.readbyqxmd.com/read/28129247/effectiveness-of-patiromer-in-the-treatment-of-hyperkalemia-in-chronic-kidney-disease-patients-with-hypertension-on-diuretics
#8
Matthew R Weir, Martha R Mayo, Dahlia Garza, Susan A Arthur, Lance Berman, David Bushinsky, Daniel J Wilson, Murray Epstein
OBJECTIVE: Recurrent hyperkalemia frequently limits use of renin-angiotensin-aldosterone system inhibitors (RAASi) in chronic kidney disease (CKD) patients with hypertension, diabetes, and/or heart failure. Patiromer is a sodium-free, nonabsorbed potassium (K)-binding polymer approved by the US Food and Drug Administration for the treatment of hyperkalemia. This post-hoc analysis of OPAL-HK examined the effectiveness and safety of patiromer in reducing serum K in hyperkalemic CKD patients on RAASi, with hypertension, receiving diuretic therapy versus those not on diuretics...
February 15, 2017: Journal of Hypertension
https://www.readbyqxmd.com/read/28122118/systematic-review-and-meta-analysis-of-patiromer-and-sodium-zirconium-cyclosilicate-a-new-armamentarium-for-the-treatment-of-hyperkalemia
#9
Calvin J Meaney, Mario V Beccari, Yang Yang, Jiwei Zhao
OBJECTIVE: To compare and contrast the efficacy and safety of patiromer and sodium zirconium cyclosilicate (ZS-9) in the treatment of hyperkalemia. DESIGN: A systematic review and meta-analysis of phase II and III clinical trial data was completed. PATIENTS OR PARTICIPANTS: Eight studies (2 phase II and 4 phase III trials with 2 subgroup analyses) were included in the qualitative analysis whereas six studies (2 phase II and 4 phase III trials) were included in the meta-analysis...
January 25, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28122064/the-impact-of-renin-angiotensin-system-blockade-on-renal-outcomes-and-mortality-in-pre-dialysis-patients-with-advanced-chronic-kidney-disease
#10
Yun Jung Oh, Sun Moon Kim, Byung Chul Shin, Hyun Lee Kim, Jong Hoon Chung, Ae Jin Kim, Han Ro, Jae Hyun Chang, Hyun Hee Lee, Wookyung Chung, Chungsik Lee, Ji Yong Jung
Renin-angiotensin-system (RAS) blockade is thought to slow renal progression in patients with chronic kidney disease (CKD). However, it remains uncertain if the habitual use of RAS inhibitors affects renal progression and outcomes in pre-dialysis patients with advanced CKD. In this multicenter retrospective cohort study, we identified 2,076 pre-dialysis patients with advanced CKD (stage 4 or 5) from a total of 33,722 CKD patients. RAS blockade users were paired with non-users for analyses using inverse probability of treatment-weighted (IPTW) and propensity score (PS) matching...
2017: PloS One
https://www.readbyqxmd.com/read/28107779/effects-of-mineralocorticoid-receptor-antagonists-on-the-progression-of-diabetic-nephropathy
#11
Li-Jing Sun, Yan-Ni Sun, Jian-Ping Shan, Geng-Ru Jiang
AIMS: We aimed to evaluate the potential benefits and adverse effects of adding a mineralocorticoid receptor antagonist (MRA) to angiotensin converting enzyme inhibitors (ACEI) and/or angiotensin receptor blockers (ARB), as standard treatment in patients with DN. MATERIALS AND METHODS: We scanned the Embase, PubMed, and Cochrane Central Register of Controlled Trials databases for human clinical trials published in English until June 2016, evaluating renal outcomes in patients with DN...
January 20, 2017: Journal of Diabetes Investigation
https://www.readbyqxmd.com/read/28090762/use-of-ace-inhibition-and-blood-pressure-management-in-deferring-dialysis-initiation
#12
Lucia Del Vecchio, Ugo Teatini, Francesco Locatelli
Elevated blood pressure is one of the most significant risk factor for the development of chronic kidney disease (CKD); its treatment is a milestone in CKD management. While it is accepted that a stricter blood pressure control is indicated in patients with proteinuria or microalbuminuria, the exact degree of blood pressure reduction to be obtained in CKD patients is still under debate. Following more recent interpretation of old trials, a BP target for < 140/90 mmHg is suggested for non-proteinuric CKD patients...
January 13, 2017: Panminerva Medica
https://www.readbyqxmd.com/read/28090229/the-impact-exerted-on-clinical-outcomes-of-patients-with-chronic-heart-failure-by-aldosterone-receptor-antagonists-a-meta-analysis-of-randomized-controlled-trials
#13
Renato De Vecchis, Claudio Cantatrione, Damiana Mazzei, Augusto Barone, Nicola Maurea
BACKGROUND: Aldosterone receptor antagonists (ARAs) have been associated with improved clinical outcomes in patients with heart failure with reduced left ventricular ejection fraction (HFREF), but not in those with heart failure with preserved left ventricular ejection fraction (HFpEF). With the aim to study this topic more deeply, we carried out a meta-analysis of selective and non-selective ARAs in HFREF and HFpEF. METHODS: We searched PubMed and Scopus databases...
February 2017: Journal of Clinical Medicine Research
https://www.readbyqxmd.com/read/28025025/a-randomized-controlled-study-of-finerenone-versus-placebo-in-japanese-patients-with-type-2-diabetes-mellitus-and-diabetic-nephropathy
#14
Shigehiro Katayama, Daishiro Yamada, Mikihiro Nakayama, Takashi Yamada, Masafumi Myoishi, Masaharu Kato, Christina Nowack, Peter Kolkhof, Yoshimitsu Yamasaki
AIMS: Finerenone (BAY 94-8862) is a novel non-steroidal mineralocorticoid receptor antagonist. The aim of this study was to compare the efficacy and safety of seven once-daily oral doses of finerenone (1.25-20mg) and placebo in 96 patients with type 2 diabetes mellitus (T2DM) and diabetic nephropathy (DN) receiving a RAS blocker. METHODS: ARTS-DN Japan was a multicenter, randomized, double-blind, placebo-controlled, phase 2b study. RESULTS: Analysis of the urinary albumin-to-creatinine ratio (UACR) at day 90 relative to baseline indicated a nominally significant effect of finerenone...
December 14, 2016: Journal of Diabetes and its Complications
https://www.readbyqxmd.com/read/28004291/sacubitril-valsartan-lcz696-in-heart-failure
#15
Yasser Khder, Victor Shi, John J V McMurray, Martin P Lefkowitz
It has been known since the 1990s that long-term morbidity and mortality is improved in patients with heart failure with reduced ejection fraction (HFrEF) by treatments that target the renin-angiotensin-aldosterone system (RAAS). It has also long been thought that enhancement of the activity of natriuretic peptides (NPs) could potentially benefit patients with HFrEF, but multiple attempts to realize this benefit had failed over the years - until 2014, when a large, phase III, randomized, controlled clinical trial (PARADIGM-HF) was completed comparing sacubitril/valsartan with enalapril, a well-established treatment for HFrEF...
December 22, 2016: Handbook of Experimental Pharmacology
https://www.readbyqxmd.com/read/27994942/effect-of-telmisartan-on-kidney-function-in-patients-with-chronic-kidney-disease-an-observational-study
#16
Ashish Agrawal, Shibnath Kamila, Swetha Reddy, Joyal Lilly, Ms Sadhguna Mariyala
Background: Globally the burden of chronic kidney disease (CKD) is rising, an important cause of death and loss of disability-adjusted life years. Activation of the renin-angiotensin-aldosterone system is involved in its pathogenesis. The aim of the present study was to examine the effects of telmisartan (40 mg/day), an angiotensin receptor blocker (ARB) in Indian patients with CKD in real-life setting. Method: This was a prospective observational study. Fifty-six patients (>18 years) diagnosed with CKD were enrolled into the study...
2016: Journal of drug assessment
https://www.readbyqxmd.com/read/27993406/tumor-lysis-syndrome-in-solid-tumors-clinical-characteristics-and-prognosis
#17
Fernando Caravaca-Fontán, Olga Martínez-Sáez, Saúl Pampa-Saico, Maria Eugenia Olmedo, Antonio Gomis, Pilar Garrido
INTRODUCTION AND OBJECTIVE: Tumour lysis syndrome (TLS) is an uncommon complication in solid tumors following treatment initiation, and its spontaneous development (STLS) is exceptional. In this study, we analyse the main clinical and prognostic features of a case series with TLS and STLS. MATERIAL AND METHODS: Observational retrospective study in which we included all patients with solid tumours diagnosed with TLS and STLS over a period of 16 years, according to Cairo-Bishop criteria...
February 9, 2017: Medicina Clínica
https://www.readbyqxmd.com/read/27958695/aldosterone-receptor-antagonists-decrease-mortality-and-cardiovascular-hospitalizations-in-chronic-heart-failure-chf-with-reduced-left-ventricular-ejection-fraction-lvef-but-not-in-chf-with-preserved-lvef-a-meta-analysis-of-randomized-controlled-trials
#18
Renato DE Vecchis, Carmelina Ariano
INTRODUCTION: Aldosterone receptor antagonists (ARAs) were introduced in the treatment of chronic heart failure (CHF), as a result of the demonstration of their protective effect on the failing heart. However, important questions remain unanswered regarding the clinical efficacy of the ARAs on the clinical and echocardiographic phenotype of heart failure, called heart failure with preserved left ventricular ejection fraction( HFpEF). EVIDENCE ACQUISITION: The aim of the present meta-analysis was to verify the impact of the ARAs on some hard endpoints, such as all - cause death and hospitalizations from cardiovascular cause, making a comparative evaluation of these outcomes in CHF patients with reduced left ventricular ejection fraction (HFREF) and in those with HFpEF, respectively...
December 13, 2016: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/27917793/high-dose-oral-furosemide-with-salt-ingestion-in-the-treatment-of-refractory-ascites-of-liver-cirrhosis
#19
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...
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
#20
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...
January 15, 2017: European Journal of Pharmacology
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