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treatment of hyperkalemia

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https://www.readbyqxmd.com/read/29350254/sacubitril-valsartan-for-heart-failure-with-reduced-left-ventricular-ejection-fraction-a%C3%A2-retrospective-cohort-study
#1
R De Vecchis, C Ariano, G Di Biase, M Noutsias
BACKGROUND: The combination drug sacubitril/valsartan was reported to be superior to enalapril in reducing all-cause death, cardiovascular mortality, and heart failure (HF) hospitalizations in patients with cardiac insufficiency and reduced left ventricular ejection fraction (HFREF) with NYHA class II-IV. METHODS: Our retrospective cohort study aimed to assess the effects of sacubitril/valsartan in addition to a beta-blocker and mineral receptor antagonist (MRA) in a group of HFREF patients with NYHA class II-III HF vs...
January 19, 2018: Herz
https://www.readbyqxmd.com/read/29345400/fludrocortisone-a-treatment-for-tubulopathy-post-paediatric-renal-transplantation-a-national-paediatric-nephrology-unit-experience
#2
S R Ali, I Shaheen, D Young, I Ramage, H Maxwell, D A Hughes, D Athavale, M G Shaikh
Calcineurin inhibitors post-renal transplantation are recognized to cause tubulopathies in the form of hyponatremia, hyperkalemia, and acidosis. Sodium supplementation may be required, increasing medication burden and potentially resulting in poor compliance. Fludrocortisone has been beneficial in addressing tubulopathies in adult studies, with limited paediatric data available. A retrospective review of data from an electronic renal database from December 2014 to January 2016 was carried out. Forty-seven post-transplant patients were reviewed with 23 (49%) patients on sodium chloride or bicarbonate...
January 18, 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29344509/review-of-the-diagnostic-evaluation-of-normal-anion-gap-metabolic-acidosis
#3
REVIEW
Kenrick Berend
Background: Normal anion gap metabolic acidosis is a common but often misdiagnosed clinical condition associated with diarrhea and renal tubular acidosis (RTA). Early identification of RTA remains challenging for inexperienced physicians, and diagnosis and treatment are often delayed. Summary: The presence of RTA should be considered in any patient with a high chloride level when the CL-/Na+ ratio is above 0.79, if the patient does not have diarrhea. In patients with significant hyperkalemia one should evaluate for RTA type 4, especially in diabetic patients, with a relatively conserved renal function...
December 2017: Kidney Diseases
https://www.readbyqxmd.com/read/29340313/treatment-of-severe-hyperkalemia-confronting-4-fallacies
#4
REVIEW
J Gary Abuelo
Severe hyperkalemia is a medical emergency that can cause lethal arrhythmias. Successful management requires monitoring of the electrocardiogram and serum potassium concentrations, the prompt institution of therapies that work both synergistically and sequentially, and timely repeat dosing as necessary. It is of concern then that, based on questions about effectiveness and safety, many physicians no longer use 3 key modalities in the treatment of severe hyperkalemia: sodium bicarbonate, sodium polystyrene sulfonate (Kayexalate [Concordia Pharmaceuticals Inc...
January 2018: KI Reports
https://www.readbyqxmd.com/read/29322723/thyrotoxic-channelopathies
#5
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/29321412/the-successful-treatment-of-sodium-polystyrene-sulfonate-induced-enteritis-diagnosed-by-small-bowel-endoscopy
#6
Kohei Okayama, Yoshikazu Hirata, Daisuke Kumai, Yuki Yamamoto, Yuki Kojima, Takuya Kanno, Hirokazu Ikeuchi, Hisato Mochizuki, Hiroki Takada, Satoshi Sobue
Sodium polystyrene sulfonate (SPS: Kayexalate®) is an ion-exchange resin used to treat hyperkalemia in patients with chronic kidney disease. It is known that this resin sometimes causes colonic necrosis and perforation, but there are few reports about small bowel necrosis associated with SPS. We herein report the case of a patient who developed SPS-induced small bowel necrosis, which was diagnosed based on the examination of a small bowel endoscopic biopsy specimen. The SPS-induced small bowel necrosis was resistant to conservative treatment including the cessation of SPS, and finally required surgical bowel resection...
January 11, 2018: Internal Medicine
https://www.readbyqxmd.com/read/29310400/clinical-analysis-of-hyperkalemia-after-esophagectomy-a-case-report
#7
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
#8
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/29244647/diagnosis-and-treatment-of-hyperkalemia
#9
REVIEW
Biff F Palmer, Deborah J Clegg
Hyperkalemia results either from the shift of potassium out of cells or from abnormal renal potassium excretion. Cell shift leads to transient increases in the plasma potassium concentration, whereas decreased renal excretion of potassium leads to sustained hyperkalemia. Impairments in renal potassium excretion can be the result of reduced sodium delivery to the distal nephron, decreased mineralocorticoid level or activity, or abnormalities in the cortical collecting duct. In some instances, all 3 of these perturbations are present...
December 2017: Cleveland Clinic Journal of Medicine
https://www.readbyqxmd.com/read/29231239/female-pattern-hair-loss-a-pilot-study-investigating-combination-therapy-with-low-dose-oral-minoxidil-and-spironolactone
#10
Rodney D Sinclair
BACKGROUND: Minoxidil and spironolactone are oral antihypertensives known to stimulate hair growth. OBJECTIVE: To report on a case series of women with pattern hair loss (PHL) treated with once daily minoxidil 0.25 mg and spironolactone 25 mg. METHODS: Women newly diagnosed with a Sinclair stage 2-5 PHL were scored for hair shedding and hair density before and after 12 months of treatment with oral minoxidil 0.25 mg and spironolactone 25 mg...
December 12, 2017: International Journal of Dermatology
https://www.readbyqxmd.com/read/29230244/tumor-lysis-syndrome-in-patients-with-hematological-malignancies
#11
REVIEW
Yohannes Belay, Ketsela Yirdaw, Bamlaku Enawgaw
Tumor lysis syndrome is a metabolic complication that may follow the initiation of cancer therapy. It commonly occurs in hematological malignant patients particularly non-Hodgkin's lymphoma and acute leukemia due to chemotherapy or spontaneously. It is characterized by a biochemical abnormality such as hyperuricemia, hyperkalemia, hyperphosphatemia, and hypocalcemia and its clinical outcome is directly related to these biochemical abnormalities. Prevention and treatment of tumor lysis syndrome depend on immediate recognition of patients at risk...
2017: Journal of Oncology
https://www.readbyqxmd.com/read/29216260/angiotensin-receptor-blockers-are-associated-with-lower-mortality-than-ace-inhibitors-in-predialytic-stage-5-chronic-kidney-disease-a-nationwide-study-of-therapy-with-renin-angiotensin-system-blockade
#12
Chih-Ching Lin, Yu-Te Wu, Wu-Chang Yang, Min-Juei Tsai, Jia-Sin Liu, Chi-Yu Yang, Szu-Yuan Li, Shuo-Ming Ou, Der-Cherng Tarng, Chih-Cheng Hsu
Dual renin angiotensin system (RAS) blockade using angiotensin-receptor blockers (ARBs) in combination with angiotensin converting enzyme inhibitors (ACEIs) is reported to improve proteinuria in both diabetic and non-diabetic patients. However, its renoprotective effect and safety remain uncertain in patients with advanced chronic kidney disease (CKD). From January 1, 2000 through June 30, 2009, we enrolled 14,117 pre-dialytic stage 5 CKD patients with serum creatinine >6mg/dL and hematocrit <28% under the treatment with erythropoiesis stimulating agents and RAS blockade...
2017: PloS One
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
#13
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...
November 7, 2017: Diagnostic Microbiology and Infectious Disease
https://www.readbyqxmd.com/read/29201470/a-novel-mutation-of-the-cyp11b2-in-a-saudi-infant-with-primary-hypoaldosteronism
#14
Lama Alfaraidi, Abrar Alfaifi, Rawan Alquaiz, Faten Almijmaj, Horia Mawlawi
Isolated hypoaldosteronism is a rare autosomal recessive disease presenting with severe salt wasting and failure to thrive in infancy. A 6-month-old Saudi girl born to consanguineous parents was referred from primary health care for failure to thrive and developmental delay. Laboratory tests revealed hyponatremia, hyperkalemia, and metabolic acidosis with high renin and low aldosterone. Blood samples were collected for endocrine and genetic studies. Sequence analysis of the CYP11B2 revealed a T to A transition at position 1398 + 2 in exon 8 of the gene in a homozygous state (c...
2017: Case Reports in Endocrinology
https://www.readbyqxmd.com/read/29200691/a-case-report-of-newly-diagnosed-epithelial-ovarian-carcinoma-presenting-with-spontaneous-tumor-lysis-syndrome-and-its-successful-management-with-rasburicase
#15
Deepak Kumar Shukla, Dinesh Gupta, Arun Aggarwal, Deepak Kumar
Tumor Lysis Syndrome (TLS) commonly occurs in hematological malignancies, but it is very rare in patients with a solid tumor. In cases of solid tumors, TLS usually occurs spontaneously or after the initiation of anticancer therapy, and it has a high mortality rate. This syndrome consists of a constellation of laboratory findings such as hyperuricemia, hyperkalemia, hyperphosphatemia, and hypocalcemia known as laboratory TLS. When clinical complications such as seizures, acute renal failure, and cardiac dysrhythmias occur in patients with laboratory TLS, the syndrome is called clinical TLS...
July 2017: Indian Journal of Medical and Paediatric Oncology
https://www.readbyqxmd.com/read/29198681/severe-hyperkalemia-complicating-voriconazole-treatment-in-a-kidney-transplant-recipient-with-histoplasmosis-a-case-report
#16
M N Nazmul, C D Miles, S G Westphal
Voriconazole is an antifungal agent that is commonly used in immunocompromised patients who develop fungal infections. We report a case of severe recurrent hyperkalemia that developed after starting voriconazole for the treatment of histoplasmosis in a kidney transplant patient who was maintained on tacrolimus-based immunosuppression. Hyperkalemia developed despite reducing the tacrolimus dose to maintain levels in a low therapeutic range. Although interactions between azoles and calcineurin inhibitors are widely recognized, this is the 1st report describing new-onset hyperkalemia following initiation of voriconazole in a kidney transplant patient receiving tacrolimus...
December 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/29180023/effect-of-patiromer-on-hyperkalemia-recurrence-in-older-chronic-kidney-disease-patients-on-renin-angiotensin-aldosterone-system-inhibitors
#17
Matthew R Weir, David A Bushinsky, Wade W Benton, Steven D Woods, Martha R Mayo, Susan P Arthur, Bertram Pitt, George L Bakris
BACKGROUND: Older people are predisposed to hyperkalemia because of impaired renal function, comorbid conditions, and polypharmacy. Renin-angiotensin-aldosterone system inhibitors (RAASi), guideline-recommended for the treatment of chronic kidney disease and heart failure, further augment the risk. Patiromer, a nonabsorbed potassium binder, was shown in a phase 3 study (OPAL-HK) to decrease serum potassium in patients with chronic kidney disease on RAASi. We studied the efficacy and safety of patiromer in a prespecified subgroup of patients aged ≥65 years from OPAL-HK...
November 24, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/29174200/group-2-adrenal-insufficiency-screening-methods-and-confirmation-of-diagnosis
#18
Philippe Chanson, Laurence Guignat, Bernard Goichot, Olivier Chabre, Dinane Samara Boustani, Rachel Reynaud, Dominique Simon, Antoine Tabarin, Damien Gruson, Yves Reznik, Marie-Laure Raffin Sanson
A diagnosis of adrenal insufficiency should be suspected in the presence of a number of non-specific symptoms (fatigue, anorexia, weight loss, hypotension, hyponatremia and hyperkalemia amongst adrenal causes of insufficiency). The diagnosis should be considered in case of pituitary disease or a state of shock. Treatment should be commenced immediately without waiting for confirmation from biochemical tests, which rely on cortisol level at 8am (expected to be low) and on ACTH level (expected to be high in the case of primary adrenal insufficiency)...
December 2017: Annales D'endocrinologie
https://www.readbyqxmd.com/read/29137346/safety-of-the-neprilysin-renin-angiotensin-system-inhibitor-lcz696
#19
REVIEW
Bo Li, Yunhe Zhao, Bo Yin, Mengfei Helian, Xinmei Wang, Feng Chen, Hongxia Zhang, Hui Sun, Bin Meng, Fengshuang An
Objectives: The combined neprilysin/rennin-angiotensin system inhibitor sacubitril/valsartan (LCZ696) has shown its superiority over ACEI/ARB therapy. In view of the existing concern of its adverse effects, we aimed to provide evidence of the safety of the new drug. Results: A total of 6 randomized trials with 11,821 subjects were included in this analysis. No significant differences were found in any adverse effects between LCZ696 and ACEI/ARB or placebo groups...
October 10, 2017: Oncotarget
https://www.readbyqxmd.com/read/29135598/cardiac-arrest-in-the-operating-room-resuscitation-and-management-for-the-anesthesiologist-part-1
#20
Vivek K Moitra, Sharon Einav, Karl-Christian Thies, Mark E Nunnally, Andrea Gabrielli, Gerald A Maccioli, Guy Weinberg, Arna Banerjee, Kurt Ruetzler, Gregory Dobson, Matthew McEvoy, Michael F O'Connor
Cardiac arrest in the operating room and procedural areas has a different spectrum of causes (ie, hypovolemia, gas embolism, and hyperkalemia), and rapid and appropriate evaluation and management of these causes require modification of traditional cardiac arrest algorithms. There is a small but growing body of literature describing the incidence, causes, treatments, and outcomes of circulatory crisis and perioperative cardiac arrest. These events are almost always witnessed, frequently known, and involve rescuer providers with knowledge of the patient and their procedure...
November 10, 2017: Anesthesia and Analgesia
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