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Hypokalemia aldosterone

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https://www.readbyqxmd.com/read/27900368/whole-exome-sequencing-reveals-an-inherited-r566x-mutation-of-the-epithelial-sodium-channel-%C3%AE-subunit-in-a-case-of-early-onset-phenotype-of-liddle-syndrome
#1
Linda M Polfus, Eric Boerwinkle, Richard A Gibbs, Ginger Metcalf, Donna Muzny, Narayanan Veeraraghavan, Megan Grove, Sanjay Shete, Stephanie Wallace, Dianna Milewicz, Neil Hanchard, James R Lupski, Syed Shahrukh Hashmi, Monesha Gupta-Malhotra
To comprehensively evaluate a European-American child with severe hypertension, whole-exome sequencing (WES) was performed on the child and parents, which identified causal variation of the proband's early-onset disease. The proband's hypertension was resistant to treatment, requiring a multiple drug regimen including amiloride, spironolactone, and hydrochlorothiazide. We suspected a monogenic form of hypertension because of the persistent hypokalemia with low plasma levels of renin and aldosterone. To address this, we focused on rare functional variants and indels, and performed gene-based tests incorporating linkage scores and allele frequency and filtered on deleterious functional mutations...
November 2016: Cold Spring Harbor Molecular Case Studies
https://www.readbyqxmd.com/read/27865304/brain-natriuretic-peptide-counteracting-the-renin-angiotensin-aldosterone-system-in-accelerated-malignant-hypertension
#2
Hitoshi Nakagawa, Yuji Mizuno, Eisaku Harada, Yoshinobu Morikawa, Koichiro Kuwahara, Yoshihiko Saito, Hirofumi Yasue
We describe 2 patients, a 52-year-old woman and a 57-year-old man, with rapidly progressive hypertension and marked elevation of brain natriuretic peptide who exhibited polyuria, natriuresis, hypokalemia, posterior reversible encephalopathy syndrome and left ventricular dysfunction together with retinopathy and nephropathy, which were attenuated in a short time span of 1-2 months with normalization of blood pressure after the antihypertensive treatment. The possible role of brain natriuretic peptide in the pathophysiology of accelerated malignant hypertension was discussed and a review of the literature was completed...
November 2016: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/27812391/use-of-aldosterone-antagonist-to-treat-diarrhea-and-hypokalemia-of-ogilvie-s-syndrome
#3
Pradhum Ram, Abhinav Goyal, Marvin Lu, Joshua Sloan, William McElhaugh
Ogilvie's syndrome (OS) is a functional obstruction of the bowel due to an autonomic imbalance. It often presents with diarrhea and is associated with hypokalemia. We present a case of a 70-year-old male who developed severe abdominal distension, watery diarrhea, and persistent hypokalemia status after left hip arthroplasty after suffering from a femoral neck fracture due to a fall and was diagnosed with OS. The persistent hypokalemia was slow to improve despite aggressive repletion because of the high potassium losses in the stool...
2016: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/27771983/potassium-supplementation-and-long-term-outcomes-in-chronic-peritoneal-dialysis-patients-with-end-stage-renal-disease-a-propensity-score-matching-study
#4
Yun-Fang Zhang, Qi Wang, Yan-Yan Su, Shen Yang, Jian Guo, Jie Luo, Jia-Min Tang, Hong-Yan Li
OBJECTIVE: In this retrospective matched-cohort study, the association between potassium supplementation and long-term outcomes was determined. METHODS: Chronic peritoneal dialysis (PD) patients, aged ≥ 16 years, being referred to four PD centers in China, with serum potassium levels ≤ 3.5 mEq/L on three consecutive monthly in Q4 2008 and without receiving oral potassium supplementation in the prior three months were included in this study. Patients were divided into two groups, either to receive (test group) or not (control group) oral potassium supplementation in both Q4 2008 and the subsequent follow-up period, until 31 December 2014...
October 24, 2016: Renal Failure
https://www.readbyqxmd.com/read/27754198/js-ish-eccr-3-a-novel-algorithm-for-the-case-detection-of-the-most-common-form-of-endocrine-hypertension
#5
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
https://www.readbyqxmd.com/read/27754112/os-22-08-prevalence-of-primary-aldosteronism-and-its-cardio-metabolic-factors-chinese-hypertensive-patients-in-xinjiang-of-china
#6
Nanfang Li, Xiaoguang Yao, Ling Zhou, Suofeiya Abulikem, Delian Zhang, Guijuan Chang, Keming Zhou
OBJECTIVE: To investigated the prevalence of primary aldosteronism (PA) and compare the pattern of PA patients with essential hypertension regarding clinical data in general hypertensive patients in Xinjiang of China. DESIGN AND METHOD: Consecutive hypertensive patients referred to Hypertension Center of Xinjiang from 2009 to 2011 underwent a diagnostic protocol composed of measurement of Na and K in serum and 24-h urine, sitting plasma renin activity, and aldosterone at baseline and after saline loading test...
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
#7
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/27753808/ssa-03-3-dietary-salt-intake-and-hypertension-in-singapore
#8
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
https://www.readbyqxmd.com/read/27669369/evaluation-of-insulin-sensitivity-and-secretion-in-primary-aldosteronism
#9
Daisuke Watanabe, Midori Yatabe, Atsuhiro Ichihara
In primary aldosteronism (PA), insulin response to glucose is not fully understood. Insulin action was elucidated using indices in 32 PA and 21 essential hypertension (EH) patients. These patients were evaluated using homeostasis model assessment (HOMA) indices, quantitative insulin sensitivity check index (QUICKI), and insulinogenic index (IGI), which were expressed for insulin sensitivity/secretion and the early phase of insulin secretion. Insulin sensitivity and early phase of insulin secretion were decreased in PA, and there was a negative correlation between serum potassium concentration and insulin sensitivity indices...
2016: Clinical and Experimental Hypertension: CHE
https://www.readbyqxmd.com/read/27643254/ssa-03-3-dietary-salt-intake-and-hypertension-in-singapore
#10
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
https://www.readbyqxmd.com/read/27643155/js-ish-eccr-3-a-novel-algorithm-for-the-case-detection-of-the-most-common-form-of-endocrine-hypertension
#11
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
https://www.readbyqxmd.com/read/27643039/os-22-08-prevalence-of-primary-aldosteronism-and-its-cardio-metabolic-factors-chinese-hypertensive-patients-in-xinjiang-of-china
#12
Nanfang Li, Xiaoguang Yao, Ling Zhou, Suofeiya Abulikem, Delian Zhang, Guijuan Chang, Keming Zhou
OBJECTIVE: To investigated the prevalence of primary aldosteronism (PA) and compare the pattern of PA patients with essential hypertension regarding clinical data in general hypertensive patients in Xinjiang of China. DESIGN AND METHOD: Consecutive hypertensive patients referred to Hypertension Center of Xinjiang from 2009 to 2011 underwent a diagnostic protocol composed of measurement of Na and K in serum and 24-h urine, sitting plasma renin activity, and aldosterone at baseline and after saline loading test...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27643002/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/27566330/diagnosing-and-managing-primary-aldosteronism-in-hypertensive-patients-a-case-based-approach
#14
REVIEW
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
https://www.readbyqxmd.com/read/27535640/primary-aldosteronism-changing-definitions-and-new-concepts-of-physiology-and-pathophysiology-both-inside-and-outside-the-kidney
#15
REVIEW
Michael Stowasser, Richard D Gordon
In the 60 years that have passed since the discovery of the mineralocorticoid hormone aldosterone, much has been learned about its synthesis (both adrenal and extra-adrenal), regulation (by renin-angiotensin II, potassium, adrenocorticotrophin, and other factors), and effects (on both epithelial and nonepithelial tissues). Once thought to be rare, primary aldosteronism (PA, in which aldosterone secretion by the adrenal is excessive and autonomous of its principal regulator, angiotensin II) is now known to be the most common specifically treatable and potentially curable form of hypertension, with most patients lacking the clinical feature of hypokalemia, the presence of which was previously considered to be necessary to warrant further efforts towards confirming a diagnosis of PA...
October 2016: Physiological Reviews
https://www.readbyqxmd.com/read/27525137/aldosterone-response-in-severe-hypokalemia-and-volume-depletion-a-case-report-and-review-of-the-recent-research
#16
Keiko Kai, Naoto Tominaga, Daisuke Uchida, Nanae Fukai, Yumie Matsuura, Susumu Uda, Akio Yokochi
We report a case of severe hypokalemia and volume depletion complicated by chronic watery diarrhea resulting from chronic alcoholism in a 57-year-old man. Prompt replacement of normal saline with potassium chloride and cessation of alcohol intake resulted in a favorable outcome. We discuss the pathophysiology of the case, emphasizing the response of aldosterone in both hypokalemia and volume depletion, and provide a review of recent research.
2016: Case Reports in Nephrology
https://www.readbyqxmd.com/read/27508685/-op-lb01-12-cacna1h-mutations-are-associated-with-young-onset-and-familial-forms-of-primary-aldosteronism
#17
G Daniil, F L Fernandes-Rosa, J Chemin, X Jeunemaitre, M Polak, S Boulkroun, L Amar, T M Strom, P Lory, M C Zennaro
OBJECTIVE: Primary aldosteronism (PA) is the most common form of secondary hypertension. Mutations in KCNJ5, ATP1A1, ATP2B3 and CACNA1D are found in aldosterone producing adenomas (APA) and familial hyperaldosteronism (FH). Recently, a recurrent germline mutation in CACNA1H (encoding the T-type voltage-dependent calcium channel Cav3.2) was identified in a new familial form of early onset hypertension and PA. DESIGN AND METHOD: To identify new genes responsible for PA, we have performed whole exome sequencing in 23 patients with APA, 10 patients with FH and in two trios with the proband presenting early onset PA...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27508647/-op-3a-05-the-use-of-prediction-score-to-diagnose-unilateral-disease-in-chinese-patients-with-primary-aldosteronism
#18
Y Zhang, H Zhnag, W L Zhou, Z J Shen, J Z Xu, X F Tang, F F Zheng, B Tao, J Zhang, X H Lu, S L Chu, P J Gao, J G Wang, L M Zhu
OBJECTIVE: Küpers et al. had proposed a clinical prediction scores to diagnose unilateral primary aldosteronism (PA). We aim to evaluate this prediction score in Chinese patients with PA. DESIGN AND METHOD: 437 patients with PA who had received AVS between 2005 and 2015 were analyzed in this retrospective study. RESULTS: Figure 1 is the flow chart of our patients with PA. According to Küpers' prediction score, the best cutoff value to discriminate unilateral from bilateral disease in our cohort was 4 points...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27460219/severe-hyperkalemia-following-adrenalectomy-for-aldosteronoma-prediction-pathogenesis-and-approach-to-clinical-management-a-case-series
#19
A Tahir, K McLaughlin, G Kline
BACKGROUND: As the field of Primary Aldosteronism (PA) becomes ever expanded, diagnosis of PA is increasingly diagnosed by endocrinologists. With increased PA screening, many of the cases are now found in patients with complex co-morbidities in addition to their hypertension. Post adrenalectomy renal impairment with hyperkalemia is now increasingly seen in these complex patients, as evidenced by the numerous reports on this issue that have appeared within the past 3 years. We present a small case series to illustrate the breadth of the problem, along with a discussion about how such CKD/hyperkalemic events may be predicted...
July 27, 2016: BMC Endocrine Disorders
https://www.readbyqxmd.com/read/27453714/hypokalemic-hypertension-leading-to-a-diagnosis-of-autosomal-dominant-polycystic-kidney-disease
#20
Wasawat Vutthikraivit, Montira Assanatham, Chutintorn Sriphrapradang
Autosomal dominant polycystic kidney disease (ADPKD) is the most common inherited renal disease. Hypertension is common and occurs before decline in renal function. However, the coexistence of hypertension and hypokalemia is rare in ADPKD patients. We report on a 32-year-old woman with secondary aldosteronism. Magnetic resonance imaging of the renal arteries revealed multiple cysts of varying sizes in both the kidneys and the liver, compatible with ADPKD. Increased reninangiotensin-aldosterone system activity was secondary to cyst expansion...
June 2016: Electrolyte & Blood Pressure: E & BP
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