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treatment of hyperkalemia

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https://www.readbyqxmd.com/read/29777284/current-drug-therapy-for-heart-failure-with-reduced-ejection-fraction
#1
D Berliner, M Hallbaum, J Bauersachs
The prevalence of heart failure has been steadily increasing during the past few years, with a further increase predicted in the years to come. Without treatment, the syndrome of heart failure has a very poor prognosis. Advances in drug treatments and the consequent implementation of a guideline-recommended drug therapy have significantly improved the prognosis in heart failure with reduced ejection fraction (HFrEF). Besides angiotensin-converting enzyme (ACE) inhibitors (ACEi) or angiotensin receptor blockers, beta-blockers and diuretics treatment with mineralocorticoid receptor antagonists and ivabradine have become standard in the therapy of symptomatic patients with HFrEF...
May 18, 2018: Herz
https://www.readbyqxmd.com/read/29772226/potential-role-of-peroxisome-proliferator-activated-receptor-gamma-activation-on-serum-visfatin-and-trace-elements-in-high-fat-diet-induced-type-2-diabetes-mellitus
#2
Arshia Tabassum, Syeda Nuzhat Fatima Zaidi, Kausar Yasmeen, Tabassum Mahboob
AIMS: Electrolytes and trace elements dysregulation play an important role in the progression of obesity and diabetes complications. The present study was designed to evaluate the insulin sensitizing effects of peroxisomes proliferators activated receptor gamma (PPAR-γ) agonist on trace elements in obesity induced type 2 diabetes mellitus and correlate with serum visfatin. MATERIALS AND METHODS: Wistar rats were categorized into five groups. Group I served as control; Group II fed on high fat diet (HFD); Group III fed on HFD and treated with rosiglitazone (3 mg/kg) for 7 days; Group IV were T2DM rats induce by HFD and low dose of streptozotocin (i...
May 14, 2018: Life Sciences
https://www.readbyqxmd.com/read/29753370/effects-of-different-doses-of-irbesartan-combined-with-spironolactone-on-urinary-albumin-excretion-rate-in-elderly-patients-with-early-type-2-diabetic-nephropathy
#3
Yingying Chen, Peng Liu, Xia Chen, Yanan Li, Fengmei Zhang, Yangang Wang
BACKGROUND: There is a lack of research on the effect of low dose of angiotensin receptor blockers combined with spironolactone, and the effect of high dose of angiotensin receptor blockers alone on the urinary albumin excretion rate (UAER) in elderly patients with early type 2 diabetic nephropathy (DN). METHODS: We conducted a prospective, randomized, open-label, parallel-controlled study that included 244 elderly patients with early DN and mild-to-moderate essential hypertension...
May 2018: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/29742971/insufficiency-of-the-zona-glomerulosa-of-the-adrenal-cortex-and-progressive-kidney-insufficiency-following-unilateral-adrenalectomy-case-report-and-discussion
#4
Joanna Kanarek-Kucner, Adrian Stefański, Rufus Barraclough, Tomasz Gorycki, Jacek Wolf, Krzysztof Narkiewicz, Michał Hoffmann
BACKGROUND: Primary aldosteronism (PA) is the most common cause of secondary hypertension and bilateral adrenal hyperplasia (BAH) and aldosterone-producing adenoma (APA) seem to be the most common causes of PA. Unilateral adrenalectomy (UA) is the preferred treatment for APA, although the benefits are still difficult to assess. CASE REPORT: We present a case report of a 69-year old man with a 30 year history of hypertension and probably long-standing PA due to APA, with typical organ complications...
May 9, 2018: Blood Pressure
https://www.readbyqxmd.com/read/29731287/controversies-in-management-of-hyperkalemia
#5
Brit Long, Justin R Warix, Alex Koyfman
BACKGROUND: Hyperkalemia is a common electrolyte disorder that can result in morbidity and mortality if not managed appropriately. OBJECTIVES: This review evaluates the classic treatments of hyperkalemia and discusses controversies and new medications for management. DISCUSSION: Potassium (K+) plays a key role in determining the transmembrane potentials of "excitable membranes" present in nerve and muscle cells. K+ is the predominant intracellular cation, and clinical deterioration typically ensues when patients develop sufficiently marked elevation in extracellular fluid concentrations of K+ (hyperkalemia)...
May 3, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29725636/treatment-of-hyperkalemia-with-a-low-dose-insulin-protocol-is-effective-and-results-in-reduced-hypoglycemia
#6
Bairbre A McNicholas, Mai H Pham, Katrina Carli, Chang Huei Chen, Nancy Colobong-Smith, Arthur Eric Anderson, Hien Pham
Introduction: Complications associated with insulin treatment for hyperkalemia are serious and common. We hypothesize that, in chronic kidney disease (CKD) and end-stage renal disease (ESRD), giving 5 units instead of 10 units of i.v. regular insulin may reduce the risk of causing hypoglycemia when treating hyperkalemia. Methods: A retrospective quality improvement study on hyperkalemia management (K+  ≥ 6 mEq/l) from June 2013 through December 2013 was conducted at an urban emergency department center...
March 2018: KI Reports
https://www.readbyqxmd.com/read/29669332/paritaprevir-ritonavir-ombitasvir-plus-dasabuvir-regimen-in-the-treatment-of-genotype-1-chronic-hepatitis-c-infection-in-patients-with-severe-renal-impairment-and-end-stage-renal-disease-a-real-life-cohort
#7
Jan Sperl, Miluse Kreidlova, Dusan Merta, Klara Chmelova, Renata Senkerikova, Sona Frankova
BACKGROUND/AIMS: Chronic hepatitis C (HCV) virus infection reactivates under immunosuppressive drugs and therefore has a negative impact on long-term survival of kidney transplant recipients. Treatment-induced clearance of hepatitis C virus (HCV) in kidney transplant candidates prevents virus reactivation after transplantation. Paritaprevir/Ritonavir/Ombitasvir with Dasabuvir (PrOD) represents a highly effective treatment regimen for HCV genotype 1 (GT1), also suitable for patients with end-stage renal disease (ESRD)...
April 13, 2018: Kidney & Blood Pressure Research
https://www.readbyqxmd.com/read/29667438/the-tolerability-and-safety-profile-of-patiromer-a-novel-polymer-based-potassium-binder-for-the-treatment-of-hyperkalemia
#8
Bertram Pitt, Dahlia Garza
Hyperkalemia (HK) occurs often among patients with chronic kidney disease (CKD) and heart failure (HF) and those treated with renin-angiotensin-aldosterone system inhibitors (RAASI). Even small deviations from normal potassium levels carry increased risk of mortality. Patiromer is approved for treatment of HK and has been shown in clinical trials to reduce serum potassium among patients with HK and comorbid conditions. Areas covered: We review pooled data from two clinical trials of patiromer in patients with CKD and HK, safety of patiromer in special populations, drug-drug interaction (DDI) studies, and other studies in healthy volunteers...
April 22, 2018: Expert Opinion on Drug Safety
https://www.readbyqxmd.com/read/29664406/racial-differences-in-characteristics-and-outcomes-of-patients-with-heart-failure-and-preserved-ejection-fraction-in-the-treatment-of-preserved-cardiac-function-heart-failure-trial
#9
Eldrin F Lewis, Brian Claggett, Amil M Shah, Jiankang Liu, Sanjiv J Shah, Inder Anand, Eileen O'Meara, Nancy K Sweitzer, Jean L Rouleau, James C Fang, Akshay S Desai, Tamrat M Retta, Scott D Solomon, John F Heitner, Thomas D Stamos, Robin Boineau, Bertram Pitt, Marc A Pfeffer
BACKGROUND: Black patients have been shown to have different baseline characteristics and outcomes compared with nonblack patients in cohort studies. However, few studies have focused on heart failure (HF) with preserved ejection fraction (HFpEF) patients. We aimed to determine the difference in cardiovascular outcomes in black and nonblack patients with HFpEF and to determine the relative efficacy and safety of spironolactone in black and nonblack patients. METHODS AND RESULTS: Patients with HFpEF, randomized to spironolactone versus placebo in the TOPCAT trial (Treatment of Preserved Cardiac Function Heart Failure With an Aldosterone Antagonist) in North and South America, were grouped according to self-described black and nonblack race...
March 2018: Circulation. Heart Failure
https://www.readbyqxmd.com/read/29662328/hyporeninemic-hypoaldosteronism-in-a-patient-with-diabetes-mellitus-an-unforgettable-case-report
#10
Naziha Chelaghma, Samson O Oyibo
A 58-year-old man presented with a 3-year history of chronic and intermittent hyperkalemia requiring recurrent attendances to the emergency department for urgent treatment. His medical history included secondary diabetes mellitus following a bout of acute pancreatitis and a previous splenectomy for a spontaneous splenic rupture. He also had a history of prolonged use of non-steroidal anti-inflammatory drugs for back pain and painful neuropathy. He was not on any medication or diet that would cause a raised serum potassium level and his renal function was normal...
2018: International Medical Case Reports Journal
https://www.readbyqxmd.com/read/29661658/is-transcellular-potassium-shifting-with-insulin-albuterol-or-sodium-bicarbonate-in-emergency-department-patients-with-hyperkalemia-associated-with-recurrent-hyperkalemia-after-dialysis
#11
Brian E Driver, Lauren R Klein, Chaitanya Chittineni, Ellen K Cales, Nathaniel Scott
BACKGROUND: Emergency department (ED) treatment of hyperkalemia often involves shifting potassium into the intracellular space. There is uncertainty whether transcellular shifting causes insufficient potassium removal during hemodialysis, resulting in a subsequent need for further medical therapy or multiple sessions of hemodialysis. OBJECTIVE: We sought to determine whether transcellular potassium shifting in ED patients with hyperkalemia who undergo hemodialysis is associated with recurrent hyperkalemia with or without repeat hemodialysis within 24 h...
April 13, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29645278/an-evaluation-of-the-pharmacodynamics-safety-and-tolerability-of-the-potassium-binder-rdx7675
#12
Bertram Pitt, Vanessa Zann, Chris Roe, Jeffrey W Jacobs, James P Davidson, Christine Dowd, Padmapriya Kumaraswamy, Fangling Lin, Paul Korner, Robert C Blanks, David P Rosenbaum
Hyperkalemia is common in patients with heart failure or chronic kidney disease, particularly those taking renin-angiotensin-aldosterone system inhibitors, and can cause arrhythmias and sudden cardiac death. The most widely used treatment, sodium polystyrene sulfonate (SPS), limits gastrointestinal potassium absorption, but has poor palatability. RDX7675 (RDX227675) is the calcium salt of a reengineered polystyrene sulfonate-based resin with improved palatability over SPS. The pharmacodynamic effects and safety of RDX7675 were assessed in a phase 1, single-center, randomized, active-controlled study...
April 12, 2018: Journal of Clinical Pharmacology
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
#13
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/29642732/evaluation-of-appropriate-sodium-polystyrene-sulfonate-use-with-a-hyperkalemia-order-set-a-pilot-study
#14
Zachary T Mueller, Andrew J Crannage
BACKGROUND: No consensus guidelines exist to assist practitioners in the management of hyperkalemia. Sodium polystyrene sulfonate (SPS) is a common treatment option for hyperkalemia. To aid health-care professionals, a hyperkalemia order set was created at a 979-bed community teaching hospital. OBJECTIVE: The objective of this study was to determine whether use of a hyperkalemia order set is associated with appropriate use of SPS. METHODS: Orders for SPS were evaluated for appropriateness in this retrospective cohort of adult patients...
January 1, 2018: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/29608741/critically-elevated-potassium-in-a-55-year-old-female-with-chronic-lymphocytic-leukemia
#15
Jing Cao, Amy B Karger
Hyperkalemia in specimens from patients with chronic lymphocytic leukemia (CLL) may be due to tumor lysis syndrome (TLS) or specimen processing. This report describes a 55-year-old Caucasian woman with CLL who presented to an outside hospital with hyperkalemia and was transferred to a second hospital. Initial evaluation on the core laboratory chemistry analyzer (the VITROS 5600) and the ABL90 FLEX blood gas analyzer showed markedly elevated levels of potassium (K+). TLS was subsequently diagnosed, and dialysis was initiated...
March 28, 2018: Laboratory Medicine
https://www.readbyqxmd.com/read/29594438/-cardio-renal-axis-relationship-of-heart-failure-and-renal-insufficiency-as-comorbidities
#16
REVIEW
M Zeisberg, M J Koziolek
Heart failure and kidney dysfunction are common comorbidities with overlapping and synergizing mechanisms. Coincidence of both pathologies aggravates disease progression rates, symptoms, and outcomes. The treatment of patients with advanced renal insufficiency is faced with limited evidence for therapies that are standard of care in patients with normal and moderate kidney failure, frequent deterioration of kidney function during therapy, and onset of hyperkalemia, which pose challenges for clinical care, requiring intensified physician-patient contacts...
May 2018: Der Internist
https://www.readbyqxmd.com/read/29588531/review-of-case-reports-on-hyperkalemia-induced-by-dietary-intake-not-restricted-to-chronic-kidney-disease-patients
#17
REVIEW
Rogier P M Te Dorsthorst, Jytte Hendrikse, Mats T Vervoorn, Valerie Y H van Weperen, Marcel A G van der Heyden
Hyperkalemia is a metabolic disturbance of the potassium balance that can cause potentially fatal cardiac arrhythmias. Kidney dysfunction and renin-angiotensin-aldosterone system inhibiting drugs are notorious for their tendency to induce hyperkalemia by decreasing the excretion of potassium. The role of dietary potassium intake in inducing hyperkalemia is less clear. We review and analyze the common presentation, laboratory, and electrocardiogram (ECG) findings and therapeutic options associated with dietary-induced hyperkalemia, and find evidence for hyperkalemia development in non-renal impaired patients...
March 27, 2018: European Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/29579289/comparative-efficacy-of-individual-renin-angiotensin-system-inhibitors-on-major-renal-outcomes-in-diabetic-kidney-disease-a-network-meta-analysis
#18
Juyu Cai, Xianxi Huang, Zhongsheng Zheng, Qing Lin, Mian Peng, Daoqian Shen
Background: Angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) are two drug classes with well-documented renal protective effects. However, whether there is any difference among individual drugs remains unknown. In this study, we aimed to compare the efficacy of individual ACEIs/ARBs on major renal outcomes in adults with diabetic kidney disease (DKD). Methods: We conducted a Bayesian-framework network meta-analysis with a random effects model...
March 22, 2018: Nephrology, Dialysis, Transplantation
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
#19
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/29553285/assessing-the-impact-of-an-order-panel-utilizing-weight-based-insulin-and-standardized-monitoring-of-blood-glucose-for-patients-with-hyperkalemia
#20
Kelby Brown, Tracy L Setji, Sarah L Hale, April Cooper, Beatrice Hong, Rebecca Herbst, R Clayton Musser, Susan Freeman, Ted Shaikewitz, Jimmy Greenlee, Noppon P Setji
Intravenous insulin with glucose is used in urgent treatment for hyperkalemia but has a significant risk of hypoglycemia. The authors developed an order panel within the electronic health record system that utilizes weight-based insulin dosing and standardized blood glucose monitoring to reduce hypoglycemia. As initial evaluation of this protocol, the authors retrospectively compared potassium and blood glucose lowering in patients treated with the weight-based (0.1 units/kg) insulin order panel (n = 195) with those given insulin based on provider judgment (n = 69)...
March 1, 2018: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
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