9,220 results match your criteria Hyperkalemia


Real-World Evaluation of Patiromer for the Treatment of Hyperkalemia in Hemodialysis Patients.

Kidney Int Rep 2019 Feb 29;4(2):301-309. Epub 2018 Oct 29.

Department of Medicine, Section of Nephrology, Baylor College of Medicine, Houston, Texas, USA.

Introduction: Patiromer is a potassium (K) binding polymer indicated for treating hyperkalemia. Among patients receiving chronic hemodialysis (HD), this study aimed to identify patient characteristics associated with patiromer initiation, describe patiromer utilization, and analyze serum K pre- and post-patiromer initiation.

Methods: In a retrospective cohort study, using electronic health record data from a large dialysis provider in the United States (study period: December 21, 2015, to December 20, 2016), HD patients were included who had a medication order for patiromer, sodium polystyrene sulfonate (SPS), or laboratory evidence of hyperkalemia (no K binder [NoKb] cohort). Read More

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http://dx.doi.org/10.1016/j.ekir.2018.10.020DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6365398PMC
February 2019

Renal function stratified dose comparisons of eplerenone versus placebo in the EMPHASIS-HF trial.

Eur J Heart Fail 2019 Feb 15. Epub 2019 Feb 15.

National Institute of Health and Medical Research (INSERM), Center for Clinical Multidisciplinary Research 1433, INSERM U1116, University of Lorraine, Regional University Hospital of Nancy, French Clinical Research Infrastructure Network (F-CRIN) Investigation Network Initiative-Cardiovascular and Renal Clinical Trialists (INI-CRCT), Nancy, France.

Background: Current heart failure guidelines recommend target eplerenone dose of 50 mg/day. We have examined the effect of different eplerenone doses based on pre-specified renal function stratification in the Eplerenone in Mild Patients Hospitalization and Survival Study in Heart Failure (EMPHASIS-HF).

Methods And Results: In EMPHASIS-HF, the target dose of eplerenone/placebo was stratified at randomization according to estimated glomerular filtration rate (eGFR): 50 mg/day if eGFR ≥ 50 mL/min/1. Read More

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http://doi.wiley.com/10.1002/ejhf.1400
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http://dx.doi.org/10.1002/ejhf.1400DOI Listing
February 2019
1 Read

WNK4 kinase is a physiological intracellular chloride sensor.

Proc Natl Acad Sci U S A 2019 Feb 14. Epub 2019 Feb 14.

Division of Nephrology, Department of Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan;

With-no-lysine (WNK) kinases regulate renal sodium-chloride cotransporter (NCC) to maintain body sodium and potassium homeostasis. Gain-of-function mutations of WNK1 and WNK4 in humans lead to a Mendelian hypertensive and hyperkalemic disease pseudohypoaldosteronism type II (PHAII). X-ray crystal structure and in vitro studies reveal chloride ion (Cl) binds to a hydrophobic pocket within the kinase domain of WNKs to inhibit its activity. Read More

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http://dx.doi.org/10.1073/pnas.1817220116DOI Listing
February 2019

Iatrogenic Takotsubo Cardiomyopathy Secondary to Norepinephrine by Continuous Infusion for Shock.

Eur J Case Rep Intern Med 2018 26;5(7):000894. Epub 2018 Jul 26.

Serviço de Medicina 1, Hospital do Espírito Santo Évora EPE, Évora, Portugal.

Takotsubo cardiomyopathy is a condition characterized by transient left ventricular systolic and diastolic dysfunction, with a possible direct causal role of catecholamine in its pathophysiology. We present a case of a woman with shock and adrenal insufficiency in whom Takotsubo cardiomyopathy developed after treatment with norepinephrine. This case confirms the direct causal role of catecholamine in the pathophysiology of Takotsubo cardiomyopathy. Read More

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https://www.ejcrim.com/index.php/EJCRIM/article/view/894
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http://dx.doi.org/10.12890/2018_000894DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6346780PMC
July 2018
1 Read

Efficacy and Safety of Dual Blockade of the Renin-Angiotensin-Aldosterone System in Diabetic Kidney Disease: A Meta-Analysis.

Am J Cardiovasc Drugs 2019 Feb 9. Epub 2019 Feb 9.

Kidney Research Institute, Division of Nephrology, West China Hospital of Sichuan University, Chengdu, 610041, Sichuan, China.

Introduction: Current guidelines recommend renin-angiotensin-aldosterone system (RAAS) inhibitors in the treatment of diabetic kidney disease (DKD). However, evidence suggests that the combined use of RAAS blockers may be associated with increased rates of adverse events.

Objectives: Our objective was to examine the efficacy and safety of dual blockade of the RAAS in patients with DKD. Read More

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http://dx.doi.org/10.1007/s40256-018-00321-5DOI Listing
February 2019
1 Read

A Unique Case of Severe Anemia Secondary to Copper Deficiency in an Adult Patient.

Cureus 2018 Nov 26;10(11):e3636. Epub 2018 Nov 26.

Internal Medicine, University of Arkansas for Medical Sciences, Little Rock, USA.

Anemia is a frequently encountered problem in the healthcare system. Common causes of anemia include blood loss, followed by impaired red blood cell production and red blood cell destruction. This case demonstrates the need for cognizance of the less frequent causes of anemia. Read More

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http://dx.doi.org/10.7759/cureus.3636DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6351007PMC
November 2018

The interplay of renal potassium and sodium handling in blood pressure regulation: critical role of the WNK-SPAK-NCC pathway.

J Hum Hypertens 2019 Feb 5. Epub 2019 Feb 5.

Endocrine Hypertension Research Centre, Greenslopes and Princess Alexandra Hospitals, The University of Queensland Faculty of Medicine, Brisbane, Australia.

Renal salt handling has a profound effect on body fluid and blood pressure (BP) maintenance as exemplified by the use of diuretic medications to treat states of volume expansion or hypertension. It has recently been proposed that a low potassium (K) intake turns on a "renal K switch" which increases sodium (Na) and chloride (Cl) reabsorption, causing salt-retention, and in susceptible individuals, this causes hypertension. A signaling network, involving with-no-lysine (WNK) kinases, underpins the switch activity to coordinate aldosterone's two essential actions (K secretion and Na retention). Read More

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http://www.nature.com/articles/s41371-019-0170-6
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http://dx.doi.org/10.1038/s41371-019-0170-6DOI Listing
February 2019
5 Reads

Influence of potassium levels on one-year outcomes in elderly patients with acute heart failure.

Eur J Intern Med 2019 02 26;60:24-30. Epub 2018 Oct 26.

Internal Medicine Department, IMIBIC/Hospital Reina Sofía, Universidad de Córdoba, Córdoba, Spain.

Background: Abnormal serum potassium levels (K) in patients with heart failure (HF) relate to worse prognosis. We evaluated whether admission K levels predict 1-year outcomes in elderly patients admitted for acute HF.

Methods: We evaluated 2865 patients aged >74 years from the RICA Spanish Heart Failure Registry, classified according to admission serum K levels: hyperkalemia (>5. Read More

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http://dx.doi.org/10.1016/j.ejim.2018.10.016DOI Listing
February 2019
2 Reads

Calcineurin dephosphorylates Kelch-like 3, reversing phosphorylation by angiotensin II and regulating renal electrolyte handling.

Proc Natl Acad Sci U S A 2019 Feb 4. Epub 2019 Feb 4.

Division of Nephrology, Department of Internal Medicine, Teikyo University School of Medicine, 173-8605 Tokyo, Japan;

Calcineurin is a calcium/calmodulin-regulated phosphatase known for its role in activation of T cells following engagement of the T cell receptor. Calcineurin inhibitors (CNIs) are widely used as immunosuppressive agents; common adverse effects of CNIs are hypertension and hyperkalemia. While previous studies have implicated activation of the Na-Cl cotransporter (NCC) in the renal distal convoluted tubule (DCT) in this toxicity, the molecular mechanism of this effect is unknown. Read More

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http://dx.doi.org/10.1073/pnas.1817281116DOI Listing
February 2019
2 Reads

A randomized controlled trial of the effect of spironolactone on left ventricular mass in hemodialysis patients.

Kidney Int 2019 Jan 29. Epub 2019 Jan 29.

Comprehensive Heart Failure Center, University and University Hospital Würzburg, Würzburg, Germany; Department of Medicine I, Division of Nephrology, University Hospital Würzburg, Würzburg, Germany.

Mineralocorticoid receptor antagonists have beneficial effects on left ventricular remodeling, cardiac fibrosis, and arrhythmia in heart failure, but efficacy and safety in dialysis patients is less clear. We evaluated the effect of spironolactone on left ventricular mass (LVM), an independent predictor of all-cause and cardiovascular mortality, in hemodialysis patients. In this placebo-controlled, parallel-group trial, 97 hemodialysis patients (23% female; mean age 60. Read More

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http://dx.doi.org/10.1016/j.kint.2018.11.025DOI Listing
January 2019
1 Read

A Rare Case of Spontaneous Tumor Lysis Syndrome in Idiopathic Primary Myelofibrosis.

Am J Case Rep 2019 Feb 3;20:146-150. Epub 2019 Feb 3.

Department of Hemato-Oncology, Chosun University Hospital, Gwangju, South Korea.

BACKGROUND Tumor lysis syndrome (TLS) is an oncologic emergency resulting from the massive destruction of tumor cells after cytotoxic chemotherapy for chemosensitive malignancies with a high tumor burden. Its clinical manifestations include severe electrolyte disturbances, metabolic acidosis, acute renal failure secondary to urate deposition in the kidney, heart, and skeletal muscle, and nervous system dysfunction. We report an extremely rare case of spontaneous TLS (STLS) in idiopathic primary myelofibrosis (PMF). Read More

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http://dx.doi.org/10.12659/AJCR.912682DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6369657PMC
February 2019
2 Reads

The value of maintaining normokalaemia and enabling RAASi therapy in chronic kidney disease.

BMC Nephrol 2019 Jan 31;20(1):31. Epub 2019 Jan 31.

Department of Cardiology, Royal Free Hospital, London, UK.

Background: People with chronic kidney disease (CKD) are at an increased risk of developing hyperkalaemia due to their declining kidney function. In addition, these patients are often required to reduce or discontinue guideline-recommended renin-angiotensin-aldosterone system inhibitor (RAASi) therapy due to increased risk of hyperkalaemia. This original research developed a model to quantify the health and economic benefits of maintaining normokalaemia and enabling optimal RAASi therapy in patients with CKD. Read More

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http://dx.doi.org/10.1186/s12882-019-1228-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6357372PMC
January 2019
1 Read

[Hyperkalemia - causes, diagnostic evaluation and treatment].

Authors:
Ralph Kettritz

Dtsch Med Wochenschr 2019 Feb 31;144(3):180-184. Epub 2019 Jan 31.

Nephrologie und Internistische Intensivmedizin, Charité-Universitätsmedizin Berlin und Experimental and Clinical Research Center a joint cooperation between the Charité Medical Faculty and the Max-Delbrück Center for Molecular Medicine Berlin-Buch.

Potassium is pivotal for membrane potentials and controls the functioning of a variety of organs, including nerves and muscles. The vast majority of potassium resides within cells. Disorders that compromise potassium influx into cells and decrease renal elimination cause hyperkalemia. Read More

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http://dx.doi.org/10.1055/a-0641-9552DOI Listing
February 2019
1 Read

Treatment of Hypothermic Cardiac Arrest in the Pediatric Drowning Victim, a Case Report, and Systematic Review.

Pediatr Emerg Care 2019 Jan 29. Epub 2019 Jan 29.

Department of Pediatrics, University of Minnesota.

Objectives: Drowning is the second leading cause of death in children. Extracorporeal membrane oxygenation (ECMO) has become the criterion standard therapy to resuscitate the hypothermic drowning victim in cardiac arrest. We present our own experience treating 5 children with hypothermic cardiac arrest in conjunction with a systematic review to analyze clinical features predictive of survival. Read More

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http://dx.doi.org/10.1097/PEC.0000000000001735DOI Listing
January 2019
1 Read

Congenital adrenal hyperplasia with salt-wasting crisis and arrhythmia: a case study.

BMJ Case Rep 2019 Jan 29;12(1). Epub 2019 Jan 29.

Department of Paediatrics, Barking Havering and Redbridge University Hospitals NHS Trust, Romford, UK.

We report a case of a 10-day-old male infant who presented to the emergency department with severe electrolyte imbalance and life-threatening arrhythmia. The parents reported a 3-day history of poor feeding and lethargy. On examination, he was bradycardic (heart rate of 65 beats/min) with signs of dehydration. Read More

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http://casereports.bmj.com/lookup/doi/10.1136/bcr-2018-22756
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http://dx.doi.org/10.1136/bcr-2018-227565DOI Listing
January 2019
20 Reads

Severe Hyperkalemia in a Hematology-Oncology Patient.

Clin Chem 2019 Feb;65(2):354-355

Department of Hemato-oncology, Faculty Hospital in Pilsen, Pilsen, Czech Republic.

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http://dx.doi.org/10.1373/clinchem.2018.290387DOI Listing
February 2019
1 Read

Peritoneal dialysis can alleviate the clinical course of hungry bone syndrome after parathyroidectomy in dialysis patients with secondary hyperparathyroidism.

Int Urol Nephrol 2019 Jan 28. Epub 2019 Jan 28.

Department of Nephrology, The First Affiliated Hospital of Nanjing Medical University, 300# Guangzhou Road, Nanjing, 210029, Jiangsu Province, China.

Purpose: It is unclear whether clinical courses of hungry bone syndrome (HBS) after parathyroidectomy (PTX) in peritoneal dialysis (PD) and hemodialysis (HD) patients are different. The present study aimed to investigate the possible differences of postoperative hypocalcemia and hyperkalemia between PD and HD patients.

Methods: We performed retrospectively 29 PD patients as the PD group and 169 HD patients as the HD group undergoing successful total PTX with autotransplantation. Read More

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http://dx.doi.org/10.1007/s11255-019-02076-7DOI Listing
January 2019
1 Read

Electrocardiographic Findings in Ventricular Paced Rhythm With Hyperkalemia.

JAMA Intern Med 2019 Jan 28. Epub 2019 Jan 28.

Division of Cardiovascular Medicine, Department of Medicine, University of Missouri-Columbia School of Medicine, Columbia, Missouri.

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http://dx.doi.org/10.1001/jamainternmed.2018.8004DOI Listing
January 2019
1 Read

A Mixed-methods Comparison of Participant and Observer Learner Roles in Simulation Education.

AEM Educ Train 2019 Jan 21;3(1):20-32. Epub 2018 Dec 21.

MGH Institute of Health Professions Boston MA.

Background: Traditional simulation-based education prioritizes participation in simulated scenarios. The educational impact of observation in simulation-based education compared with participation remains uncertain. Our objective was to compare the performances of observers and participants in a standardized simulation scenario. Read More

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http://dx.doi.org/10.1002/aet2.10310DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6339532PMC
January 2019
1 Read

Clinical Characteristics and Electrophysiological Mechanisms Underlying Brugada ECG in Patients With Severe Hyperkalemia.

J Am Heart Assoc 2019 Feb;8(3):e010115

1 Department of Cardiology Hospital General Universitario Gregorio Marañón Instituto de Investigación Sanitaria Gregorio Marañón Facultad de Medicina Universidad Complutense Madrid Spain.

Background Several metabolic conditions can cause the Brugada ECG pattern, also called Brugada phenotype (BrPh). We aimed to define the clinical characteristics and outcome of BrPh patients and elucidate the mechanisms underlying BrPh attributed to hyperkalemia. Methods and Results We prospectively identified patients hospitalized with severe hyperkalemia and ECG diagnosis of BrPh and compared their clinical characteristics and outcome with patients with hyperkalemia but no BrPh ECG. Read More

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http://dx.doi.org/10.1161/JAHA.118.010115DOI Listing
February 2019
2 Reads

New options for the management of chronic hyperkalemia.

Kidney Int Suppl (2011) 2017 Dec 17;7(3):164-170. Epub 2017 Nov 17.

Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA.

Hyperkalemia is a frequently detected electrolyte abnormality that can cause life-threatening complications. Hyperkalemia is most often the result of intrinsic (decreased glomerular filtration rate; selective reduction in distal tubule secretory function; impaired mineralocorticoid activity; and metabolic disturbances, such as acidemia and hyperglycemia) and extrinsic factors (e.g. Read More

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http://dx.doi.org/10.1016/j.kisu.2017.09.001DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6341013PMC
December 2017
1 Read

Mineralocorticoid Antagonism and Diabetic Kidney Disease.

Curr Diab Rep 2019 Jan 23;19(1). Epub 2019 Jan 23.

Department of Medicine, Division of Nephrology, University Health Network, University of Toronto, Toronto, Canada.

Purpose Of Review: Type 2 diabetes (T2D) is associated with an increased risk of diabetic kidney disease (DKD), cardiovascular disease, and heart failure, in part through activation of the renin-angiotensin-aldosterone system (RAAS). Although recent cardiovascular outcome trials have identified newer therapeutic agents such as sodium-glucose cotransporter-2 (SGLT-2) inhibitors and glucagon-like peptide-1 (GLP-1)-receptor agonists that reduce the risk of these complications, patients still exhibit residual cardiorenal morbidity and mortality. Accordingly, the identification of pharmacological agents that attenuate micro- and macrovascular complications related to T2D is a major priority. Read More

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http://dx.doi.org/10.1007/s11892-019-1123-8DOI Listing
January 2019
5 Reads

Rectal ulcer due to Kayexalate deposition - an unusual case.

Rev Assoc Med Bras (1992) 2018 Aug;64(8):680-683

. Internal Medicine Department, Medicine Service III - Santarém Hospital - Santarém, Santarém, Portugal.

Sodium polystyrene sulfonate (PSP) or Kayexalate is a cation-exchange resin, widely used in the management of hyperkalaemia due to renal disease. A rare, yet potentially dangerous, adverse event related to sodium polystyrene sulfonate use is intestinal mucosal injury, especially in the colon. The injury to the gastrointestinal mucosa can range from mild and superficial to wall necrosis and bowel perforation. Read More

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http://dx.doi.org/10.1590/1806-9282.64.08.680DOI Listing
August 2018
4 Reads

Profile and outcome of patients with emergency complications of renal failure presenting to an urban emergency department of a tertiary hospital in Tanzania.

BMC Emerg Med 2019 Jan 22;19(1):11. Epub 2019 Jan 22.

Emergency Medicine Department, Muhimbili University of Health and Allied Science, P.O Box 65001, Dar es Salaam, Tanzania.

Background: Renal failure carries high mortality even in high-resource countries. Little attention has been paid to renal failure patients presenting acutely in emergency care settings in low-to-middle income countries (LMIC). Our aim was to describe the profile, management strategies and outcome of renal failure patients presenting with indications for emergent dialysis to an urban Emergency Department (ED) in a tertiary public hospital in Tanzania. Read More

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http://dx.doi.org/10.1186/s12873-019-0229-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6341653PMC
January 2019
2 Reads

Brugada phenocopy induced by hyperkalemia.

Kidney Int 2019 Feb;95(2):471

Renal Division, Department of Internal Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.

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http://dx.doi.org/10.1016/j.kint.2018.07.014DOI Listing
February 2019
1 Read

23.4% Hypertonic Saline and Intracranial Pressure in Severe Traumatic Brain Injury Among Children: A 10-Year Retrospective Analysis.

Pediatr Crit Care Med 2019 Jan 18. Epub 2019 Jan 18.

Department of Pediatrics, Hennepin Healthcare, Minneapolis, MN.

Objective: To explore the effect of 23.4% hypertonic saline for management of elevated intracranial pressure in children admitted to our institution for severe traumatic brain injury.

Design: Single-center, retrospective medical chart analysis. Read More

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http://dx.doi.org/10.1097/PCC.0000000000001867DOI Listing
January 2019
2 Reads

Quantitative Evaluation of the Relationship between T-Wave-Based Features and Serum Potassium Level in Real-World Clinical Practice.

Biomed Res Int 2018 18;2018:3054316. Epub 2018 Dec 18.

Department of Biomedical Informatics, Ajou University School of Medicine, Suwon, Gyeonggi-do, Republic of Korea.

Background: Proper management of hyperkalemia that leads to fatal cardiac arrhythmia has become more important because of the increased prevalence of hyperkalemia-prone diseases. Although T-wave changes in hyperkalemia are well known, their usefulness is debatable. We evaluated how well T-wave-based features of electrocardiograms (ECGs) are correlated with estimated serum potassium levels using ECG data from real-world clinical practice. Read More

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http://dx.doi.org/10.1155/2018/3054316DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6312577PMC
December 2018
6 Reads

[Hypermagnesemia of ionized magnesium in 199 dogs - A hospital population-based study on prevalence, etiology and prognosis with special emphasis on kidney disease and the measurement of total magnesium].

Tierarztl Prax Ausg K Kleintiere Heimtiere 2018 Dec 18;46(6):370-379. Epub 2019 Jan 18.

Objective: To investigate the prevalence and etiology of an increased concentration of ionized magnesium (iMg) in dogs and to evaluate its prognostic relevance.

Materials And Methods: From April 2009 to December 2013, serum electrolytes were measured in 9950 dogs using an ion-selective electrode. Inclusion criterion was an iMg concentration ≥ 0. Read More

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http://dx.doi.org/10.1055/s-0038-1677389DOI Listing
December 2018
2 Reads

Sodium zirconium cyclosilicate (Lokelma) for hyperkalemia.

Authors:

Med Lett Drugs Ther 2018 Dec;60(1561):197-199

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December 2018
1 Read

Delayed malposition of a double-lumen hemodialysis catheter that caused hemorrhage and hypovolemic shock: A case report.

Medicine (Baltimore) 2019 Jan;98(3):e14192

Department of Emergency Medicine, Kaohsiung Medical University Hospital.

Rationale: Double-lumen hemodialysis catheters are commonly used as temporary hemodialysis routes. Complications include infection, thrombosis, cardiac arrhythmia, entrapped guide wire, and malposition. We report a rare complication of delayed hemodialysis catheter malposition that caused retroperitoneal hemorrhage and hypovolemic shock during hemodialysis. Read More

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http://dx.doi.org/10.1097/MD.0000000000014192DOI Listing
January 2019
1 Read

Perioperative hyperkalemia in hemodialysis patients undergoing parathyroidectomy for renal hyperparathyroidism.

Intern Emerg Med 2019 Jan 16. Epub 2019 Jan 16.

Department of Nephrology, The First Affiliated Hospital of Nanjing Medical University, 300# Guangzhou Road, Nanjing, 210029, Jiangsu, China.

The present study investigates the incidence of perioperative hyperkalemia and the influence factors of serum potassium levels during and after parathyroidectomy (PTX) in hemodialysis patients with renal hyperparathyroidism (rHPT). A total of 204 hemodialysis patients with refractory rHPT undergoing successful total parathyroidectomy with autotransplantation (tPTX + AT) were analyzed retrospectively. Hyperkalemia was defined as serum potassium levels ≥ 5. Read More

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http://link.springer.com/10.1007/s11739-019-02031-5
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http://dx.doi.org/10.1007/s11739-019-02031-5DOI Listing
January 2019
3 Reads

Pseudohyperkalemia: To Treat or not to Treat.

Cureus 2018 Nov 10;10(11):e3570. Epub 2018 Nov 10.

Internal Medicine, Florida Hospital, Orlando, USA.

Chronic lymphocytic leukemia (CLL) is characterized by excessive production of abnormal lymphocytes in the bone marrow. It usually presents as hepatosplenomegaly and lymphadenopathy along with constitutional symptoms of fever, tiredness, and weight loss. Pseudohyperkalemia may occur in patients with extreme leukocytosis. Read More

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http://dx.doi.org/10.7759/cureus.3570DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6329613PMC
November 2018
1 Read

Association of Changes in Creatinine and Potassium Levels After Initiation of Renin Angiotensin Aldosterone System Inhibitors With Emergency Department Visits, Hospitalizations, and Mortality in Individuals With Chronic Kidney Disease.

JAMA Netw Open 2018 Nov 2;1(7):e183874. Epub 2018 Nov 2.

Department of Medicine, Renal Division, Brigham & Women's Hospital, Boston, Massachusetts.

Importance: Renin angiotensin aldosterone system inhibitors (RAASIs) benefit individuals with chronic kidney disease (CKD). Elevations in serum creatinine and potassium levels are common reasons for discontinuation of this therapy, but their incidence and risks are not well characterized in community practice.

Objective: To evaluate associations of increased creatinine levels, hyperkalemia, and therapy continuation with the risk of emergency department (ED) visits, hospitalizations, and mortality within 1 year after RAASI therapy initiation in individuals with CKD. Read More

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http://dx.doi.org/10.1001/jamanetworkopen.2018.3874DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6324397PMC
November 2018
2 Reads

Extracorporeal potassium binding for the management of hyperkalemia in an anephric model of crush injury.

J Trauma Acute Care Surg 2019 Jan 10. Epub 2019 Jan 10.

Clinical Investigation Facility, David Grant USAF Medical Center, Travis Air Force Base, CA.

Background: Potassium-binding polymers have shown promising results in an anephric porcine hyperkalemia model. The benefits of the polymer in a clinically-relevant injury model remain unknown. We hypothesized that potassium-binding cartridges would control serum potassium concentration in a porcine hemorrhagic shock model with supraceliac aortic occlusion and a limb crush injury. Read More

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http://dx.doi.org/10.1097/TA.0000000000002178DOI Listing
January 2019
3 Reads

Effects of anoxia on ATP, water, ion and pH balance in an insect ().

J Exp Biol 2019 Jan 10. Epub 2019 Jan 10.

Zoophysiology, Department of Bioscience, Aarhus University, 8000 Aarhus C, Denmark

When exposed to anoxia insects rapidly go into a hypometabolic coma from which they can recover when exposed to normoxia again. However, prolonged anoxic bouts eventually lead to death in most insects, although some species are surprisingly tolerant. Anoxia challenges ATP, ion, pH and water homeostasis, but it is not clear how fast and to what degree each of these parameters are disrupted during anoxia, nor how quickly they recover. Read More

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http://dx.doi.org/10.1242/jeb.190850DOI Listing
January 2019
1 Read

Serum potassium and clinical outcomes in heart failure patients: results of risk calculations in 21 334 patients in the UK.

ESC Heart Fail 2019 Jan 10. Epub 2019 Jan 10.

Health Economics and Outcomes Research Ltd, Cardiff, UK.

Aims: At present, the clinical burden of hypokalaemia and hyperkalaemia among European heart failure patients, and relationships between serum potassium and adverse clinical outcomes in this population, is not well characterized. The aim of this study was to investigate associations between mortality, major adverse cardiac events, and renin-angiotensin-aldosterone system inhibitor (RAASi) discontinuation across serum potassium levels, in a UK cohort of incident heart failure patients.

Methods And Results: This was a retrospective observational cohort study of newly diagnosed heart failure patients listed in the Clinical Practice Research Datalink, with a first record of heart failure (index date) between 2006 and 2015. Read More

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http://dx.doi.org/10.1002/ehf2.12402DOI Listing
January 2019
2 Reads

[The 'Dangerous' ECG].

Authors:
Gian Flury

Praxis (Bern 1994) 2019 Jan;108(1):45-52

1 Innere Medizin und Kardiologie, Ospidal, Gesundheitszentrum Unterengadin, Scuol.

The 'Dangerous' ECG Abstract. This review aims to draw the attention of physicians confronted with cardiac emergencies to some specific ECG pathomorphologies in acute coronary syndrome and pulmonary embolism, as well as to malignant arrhythmias in hyperkalemia, drug-induced QTc prolongation, WPW, and arrhythmogenic right ventricular cardiomyopathy. If they are not detected the resultant failure to treat or incorrect treatment can have serious consequences for the patient and the doctor (liability consequences). Read More

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http://dx.doi.org/10.1024/1661-8157/a003155DOI Listing
January 2019
1 Read

Tumour lysis syndrome.

Med Clin (Barc) 2019 Jan 3. Epub 2019 Jan 3.

Servicio de Hematología y Hemoterapia, Hospital Universitario Miguel Servet, Zaragoza, España. Electronic address:

Tumour lysis syndrome (TLS) is a life-threatening emergency characterised by a massive cytolysis with the release of intracellular electrolytes, nucleic acids, and metabolites into the circulation. TLS comprises laboratory derangements (hyperuricaemia, hyperkalaemia, hyperphosphataemia, and hypocalcaemia) responsible for acute kidney injury. In patients with hematologic malignancies after cytotoxic therapy or spontaneously and also in advanced solid tumours. Read More

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http://dx.doi.org/10.1016/j.medcli.2018.10.029DOI Listing
January 2019
2 Reads

Comparison of Outcomes in Patients With Diabetes Mellitus Treated With Versus Without Insulin + Heart Failure With Preserved Left Ventricular Ejection Fraction (from the TOPCAT Study).

Am J Cardiol 2019 Feb 24;123(4):611-617. Epub 2018 Nov 24.

Montreal Heart Institute, Montreal, Quebec.

We aimed to evaluate the impact of diabetes mellitus (DM) and insulin treatment on clinical outcomes in patients with heart failure and preserved left ventricular ejection fraction enrolled in the TOPCAT study. We investigated the influence of DM status (insulin-treated [ITDM], non-insulin treated [NITDM], and no diabetes [non-DM]) at baseline on time to development of the primary end point, a composite of cardiovascular (CV) mortality, heart failure hospitalization, and aborted cardiac arrest. Secondary end points included the individual components of the primary end point, myocardial infarction, stroke, all-cause mortality, hyperkalemia, and worsened renal function. Read More

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http://dx.doi.org/10.1016/j.amjcard.2018.11.022DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6349530PMC
February 2019
2 Reads
3.276 Impact Factor

Balancing Benefits and Risks of Spironolactone in HFpEF and Chronic Kidney Disease Patients: Mind the Gap of Biological Monitoring!

JACC Heart Fail 2019 Jan;7(1):33-35

Université de Lorraine, Inserm, Centre d'Investigations Cliniques- Plurithématique 14-33, and Inserm U1116, CHRU, F-CRIN INI-CRCT (Cardiovascular and Renal Clinical Trialists), Nancy, France.

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http://dx.doi.org/10.1016/j.jchf.2018.11.016DOI Listing
January 2019
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Efficacy and Safety of Spironolactone in Patients With HFpEF and Chronic Kidney Disease.

JACC Heart Fail 2019 Jan;7(1):25-32

Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts. Electronic address:

Objectives: This study investigated the association between baseline renal function and the net benefit of spironolactone in patients with heart failure (HF) with a preserved ejection fraction (HFpEF).

Background: Guidelines recommend consideration of spironolactone to reduce HF hospitalization in HFpEF. However, spironolactone may increase risk for hyperkalemia and worsening renal function, particularly in patients with chronic kidney disease. Read More

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http://dx.doi.org/10.1016/j.jchf.2018.10.017DOI Listing
January 2019
1 Read

Cardiorenal Syndrome in Acute Kidney Injury.

Semin Nephrol 2019 Jan;39(1):31-40

International Renal Research Institute, S. Bortolo Hospital, Vicenza, Italy.

Varying degrees of cardiac and kidney dysfunction commonly are observed in hospitalized patients. As a demonstration of the significant interplay between the heart and kidneys, dysfunction or injury of one organ often contributes to dysfunction or injury of the other. The term cardiorenal syndrome (CRS) was proposed to describe this complex organ cross-talk. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S02709295183015
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http://dx.doi.org/10.1016/j.semnephrol.2018.10.003DOI Listing
January 2019
14 Reads

Rasburicase induced severe hemolysis and methemoglobinemia in a Caucasian patient complicated by acute renal failure and ARDS.

Respir Med Case Rep 2019 23;26:142-145. Epub 2018 Dec 23.

Pulmonary and Critical Care Medicine, Marshall University School of Medicine, Huntington, WV, USA.

Rasburicase is a recombinant urate-oxidase enzyme and is a very important medication for tumor lysis syndrome. Methemoglobinemia and hemolysis are known side effects of rasburicase that result from oxidative stress caused by hydrogen peroxide, a byproduct generated during the breakdown of uric acid to allantoin. Patients with G6PD deficiency have a decreased tolerance to oxidative stress and are therefore at a greater risk of hemolysis and methemoglobinemia with rasburicase. Read More

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http://dx.doi.org/10.1016/j.rmcr.2018.12.011DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6307101PMC
December 2018
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Identification of Mineralocorticoid Receptor Modulators with Low Impact on Electrolyte Homeostasis but Maintained Organ Protection.

J Med Chem 2019 Jan 30. Epub 2019 Jan 30.

Pharmaron Beijing Co., Ltd. , No. 6 Taihe Road, BDA , Beijing 100176 , P. R. China.

The mechanism-based risk for hyperkalemia has limited the use of mineralocorticoid receptor antagonists (MRAs) like eplerenone in cardio-renal diseases. Here, we describe the structure and property-driven lead generation and optimization, which resulted in identification of MR modulators ( S)-1 and ( S)-33. Both compounds were partial MRAs but still demonstrated equally efficacious organ protection as eplerenone after 4 weeks of treatment in uni-nephrectomized rats on high-salt diet and aldosterone infusion. Read More

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http://pubs.acs.org/doi/10.1021/acs.jmedchem.8b01523
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http://dx.doi.org/10.1021/acs.jmedchem.8b01523DOI Listing
January 2019
3 Reads

Benefit of point of care testing in patient with major hyperleukocytosis.

Clin Biochem 2018 Dec 25. Epub 2018 Dec 25.

CHU Lille, Service de Biochimie automatisée Protéines, F-59000 Lille, France.

We report a case of a child with major leukocytosis (800 × 10/L) leading to a false increase in plasma potassium and an unexpected spurious decrease in sodium. To suppress interferences due to hyperleukocytosis, our laboratory protocol consists of collecting blood on Clotting Activator/Serum tubes (CAS) and/or carrying samples by human courier. CAS tube analysis showed a decreased level of hyperkalemia and sodium within the reference range (consistent with point of care measurements). Read More

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http://dx.doi.org/10.1016/j.clinbiochem.2018.12.011DOI Listing
December 2018
7 Reads

[Clinical analysis of perioperative electrolyte imbalance in 999 patients undergoing gastrointestinal surgery].

Zhonghua Wei Chang Wai Ke Za Zhi 2018 Dec;21(12):1427-1432

Department of Anesthesia, the Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou 510655, China,

Objective: To investigate the perioperative electrolyte imbalance in patients undergoing gastrointestinal surgery.

Methods: Retrospective case analysis was used in this study. Patients who underwent gastrointestinal surgery under general anesthesia at the Sixth Affiliated Hospital of Sun Yat-sen University from January to April 2018 were selected through electronic medical records system. Read More

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December 2018
2 Reads

Plant-Based Diets in CKD.

Clin J Am Soc Nephrol 2019 Jan 26;14(1):141-143. Epub 2018 Dec 26.

Department of Nutrition Science, Purdue University, West Lafayette, Indiana; and.

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http://dx.doi.org/10.2215/CJN.08960718DOI Listing
January 2019
2 Reads

Pathogenesis and treatment of electrolyte problems post transplant.

Authors:
Erin Kim

Curr Opin Pediatr 2018 Dec 21. Epub 2018 Dec 21.

Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas, USA.

Purpose Of Review: Electrolyte abnormalities posttransplant are common occurrences that can have significant short-term and long-term effects on graft outcome and patient quality of life. Understanding the pathophysiology of these electrolyte derangements can help guide management to optimize bone health and minimize cardiovascular disease. This review explores the pathogenesis of the most common postrenal transplant electrolytes abnormalities as well as current treatment options. Read More

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http://dx.doi.org/10.1097/MOP.0000000000000715DOI Listing
December 2018
3 Reads

Renin-angiotensin system inhibition in advanced chronic kidney disease: how low can the kidney function go?

Curr Opin Nephrol Hypertens 2019 Mar;28(2):171-177

Division of Nephrology, Department of Medicine, Duke University School of Medicine.

Purpose Of Review: To present the available data on the risks and benefits for ACEi/ARB usage in patients with advanced CKD.

Recent Findings: It has been well established that ACEi/ARB use is beneficial in patients with mild-to-moderate CKD, especially in patients with proteinuria. The majority of available data includes patients with diabetes mellitus. Read More

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http://dx.doi.org/10.1097/MNH.0000000000000484DOI Listing
March 2019
3 Reads

Rhabdomyolysis and Acute Poisoning; a Brief Report.

Emerg (Tehran) 2018 26;6(1):e56. Epub 2018 Sep 26.

Loghman-Hakim Hospital Poison Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Introduction: Some studies have reported creatinine phosphokinase (CPK) as a new emerging way in predicting the outcomes of poisoned patients. This study aimed to evaluate the association of serum CPK level in the first 24 hours with outcomes of poisoned patients.

Methods: This retrospective cross-sectional study was performed using the medical profiles of poisoned patients aged between 13 and 70 years old who were referred to the emergency department of a big referral medical toxicology center during 6 years and whose necessary data for this study was available. Read More

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6289148PMC
September 2018
1 Read