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    1 OF 177

    Smith-Lemli-Opitz syndrome: clinical and biochemical correlates.
    J Pediatr Endocrinol Metab 2018 Feb 19. Epub 2018 Feb 19.
    Victorian Clinical Genetics Services, Murdoch Children's Research Institute, Melbourne, Australia.
    Background: Smith-Lemli-Opitz syndrome (SLOS) is an autosomal recessive disorder caused by mutations in the DHCR7 gene that result in reduced cholesterol biosynthesis. The aim of the study was to examine the biochemical and clinical features of SLOS in the context of the emerging evidence of the importance of cholesterol in morphogenesis and steroidogenesis.

    Methods: We retrospectively reviewed the records of 18 patients (including four fetuses) with confirmed SLOS and documented their clinical and biochemical features. Read More

    Trimethoprim use for urinary tract infection and risk of adverse outcomes in older patients: cohort study.
    BMJ 2018 Feb 9;360:k341. Epub 2018 Feb 9.
    Department of Non-communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK.
    Objective: To determine if trimethoprim use for urinary tract infection (UTI) is associated with an increased risk of acute kidney injury, hyperkalaemia, or sudden death in the general population.

    Design: Cohort study.

    Setting: UK electronic primary care records from practices contributing to the Clinical Practice Research Datalink linked to the Hospital Episode Statistics database. Read More

    Early-onset neonatal hyperkalemia associated with maternal hypermagnesemia: a case report.
    BMC Pediatr 2018 02 13;18(1):55. Epub 2018 Feb 13.
    Division of Neonatology, Kumamoto University Hospital, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan.
    Background: Neonatal nonoliguric hyperkalemia (NOHK) is a metabolic abnormality that occurs in extremely premature neonates at approximately 24 h after birth and is mainly due to the immature functioning of the sodium (Na)/potassium (K) pump. Magnesium sulfate is frequently used in obstetrical practice to prevent preterm labor and to treat preeclampsia; this medication can also cause hypermagnesemia and hyperkalemia by a mechanism that is different from that of NOHK. Herein, we report the first case of very early-onset neonatal hyperkalemia induced by maternal hypermagnesemia. Read More

    A randomized controlled trial comparing C Mac D Blade and Macintosh laryngoscope for nasotracheal intubation in patients undergoing surgeries for head and neck cancer.
    Saudi J Anaesth 2018 Jan-Mar;12(1):35-41
    Department of Anesthesiology, Rajiv Gandhi Cancer Institute and Research Centre, Sector V, Rohini, New Delhi, India.
    Purpose: Several devices are available to take care of difficult airway, but C-MAC D-Blade has scant evidence of its use in nasotracheal intubation in a difficult airway scenario.

    Aims And Objectives: We compared the C-MAC D-Blade videolaryngoscope, and the standard Macintosh laryngoscope for nasal intubation in patients with difficult airways selected by El-Ganzouri risk index using parameters of time and attempts required for intubation, glottic view in terms of Cormack-Lehane grade, ease of intubation, success rate, use of accessory maneuvers, incidence of complications, and hemodynamic changes.

    Methods: One hundred American Society of Anesthesiologists (ASA) I-III patients aged 20-70 years with EGRI score 1-≤7 scheduled for head and neck surgery requiring nasal intubation. Read More

    Hyperkalemia Was an Independent Risk Factor for Death While Under Mechanical Ventilation Among Children Hospitalized With Diarrhea in Bangladesh.
    Glob Pediatr Health 2018 24;5:2333794X17754005. Epub 2018 Jan 24.
    International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh.
    . We sought to evaluate the admission and hospital risk factors for death in children with diarrhea requiring mechanical ventilation (MV).. Read More

    Relation of the Brugada Phenocopy to Hyperkalemia (from the International Registry on Brugada Phenocopy).
    Am J Cardiol 2017 Dec 29. Epub 2017 Dec 29.
    Department of Medicine, Queen's University, Kingston, Ontario, Canada. Electronic address:
    Brugada phenocopies (BrPs) are clinical entities that differ in etiology from true congenital Brugada syndrome but have identical electrocardiographic (ECG) patterns. Hyperkalemia is known to be one of the causes of BrP. The aim of this study was to determine the clinical characteristics and evolution of hyperkalemia-induced BrP. Read More


    Thoracic Endovascular Repair for Acute Traumatic Transection of the Descending Thoracic Aorta and Postendovascular Remodeling Change.
    Thorac Cardiovasc Surg 2018 Feb 2. Epub 2018 Feb 2.
    Departments of Thoracic and Cardiovascular Surgery, Inha University Hospital, Incheon, Republic of Korea.
    Background:  The recently developed thoracic endovascular repair (TEVAR) technique seems to offer a good alternative for treating acute traumatic transection of the thoracic aorta (TTA). We reviewed our experience of TEVAR in cases of acute traumatic transection and analyzed the subsequent remodeling changes.

    Methods:  The medical records of 17 patients who underwent TEVAR for TTA were reviewed. Read More

    Hyperkalemia in electrical burns: A retrospective study in Colombia.
    Burns 2018 Jan 30. Epub 2018 Jan 30.
    Emergency Physician, Clinical Epidemiology, Burn Intensive Care Unit, U.S.S. Simón Bolívar Hospital, Bogotá, Colombia. Electronic address:
    Introduction: Classically, hyperkalemia has been regarded as a complication in patients with electrical burns. The etiology of hyperkalemia includes metabolic acidosis, destruction of red blood cells, rhabdomyolysis and the development of renal failure. The purpose of this study was to determine the prevalence of hyperkalemia within the first 24h after electrical burn injury and to evaluate the possible association of serum potassium concentration with cutaneous burn size (%TBSA) and serum creatine phosphokinase (CPK) concentration. Read More

    Ozone therapy induced sinus arrest in a hypertensive patient with chronic kidney disease: A case report.
    Medicine (Baltimore) 2017 Dec;96(50):e9265
    Department of Hypertension, Beijing Anzhen Hospital of Capital Medical University, Beijing, China.
    Rationale: Ozone autohemotherapy as an alternative treatment method has been applied to the treatment of several diseases. Here, we report a patient used ozone autohemotherapy to treat her hypertension and diabetes. Nevertheless, the patient occurred sudden dizziness and black haze due to hyperkalemia. Read More

    Longitudinal AddiQoL scores may identify higher risk for adrenal crises in Addison's disease.
    Endocrine 2018 Jan 31. Epub 2018 Jan 31.
    Division of Endocrinology, Department of Internal Medicine 1, Goethe-University Hospital, Frankfurt, Germany.
    Purpose: Several studies have shown a reduced quality of life (QoL) in patients with Addison's disease (AD), but investigations of QoL over a long-term course are lacking. Adrenal crises (AC) are life-threatening complications in AD. The purpose of this prospective study was to test whether the repeated use of QoL-questionnaires can detect prodromal periods of an AC. Read More

    Evidence in support of hyperkalaemia management strategies: A systematic literature review.
    Int J Clin Pract 2018 Jan 30. Epub 2018 Jan 30.
    AstraZeneca, Gaithersburg, USA.
    Background: Hyperkalaemia is a potentially life-threatening condition that can be managed with pharmacological and non-pharmacological approaches. With the recent development of new hyperkalaemia treatments, new information on safe and effective management of hyperkalaemia has emerged.

    Objectives: This systematic literature review (SLR) aimed to identify all relevant comparative and non-comparative clinical data on management of hyperkalaemia in adults. Read More

    Apparent pacemaker dysfunction during peptide receptor radionuclide therapy for neuroendocrine tumor.
    Clin Case Rep 2018 Jan 14;6(1):197-199. Epub 2017 Dec 14.
    Cardiology and Angiology IHeart CenterFreiburg UniversityFreiburgGermany.
    This case is a reminder not to overlook rare causes of electrolyte shifts, which may cause reversible changes in pacemaker pacing thresholds. Read More

    Renal Considerations in the Treatment of Hypertension.
    Am J Hypertens 2018 Jan 24. Epub 2018 Jan 24.
    Internal Medicine Biomedical Research Department Diabetes and Obesity Research Division Cedars-Sinai Medical Center Los Angeles, California.
    There are renal implications when employing intensive blood pressure control strategies. While this approach provides cardiovascular benefit in patients with and without chronic kidney disease, the impact on renal disease progression differs according to the pattern of underlying renal injury. In the setting of proteinuria, stringent blood pressure control has generally conferred a protective effect on renal disease progression, but in the absence of proteinuria, this benefit tends to be much less impressive. Read More

    Hypercalcemia, hyperkalemia and supraventricular tachycardia in a patient with subcutaneous fat necrosis.
    J Pediatr Endocrinol Metab 2018 Jan 26. Epub 2018 Jan 26.
    Rutgers Robert Wood Johnson Medical School, Department of Pediatrics, Division of Pediatric Endocrinology, New Brunswick, NJ, USA.
    Background: Subcutaneous fat necrosis (SCFN) is a rare, self-limiting condition that has been associated with several complications including hypercalcemia.

    Case Presentation: We present the case of a 6-week-old male who presented to his pediatrician with a dime-sized erythematous nodule consistent with SCFN, who was also found to have supraventricular tachycardia (SVT). Laboratory findings revealed hypercalcemia and hyperkalemia. Read More

    New Therapeutic Approaches for the Treatment of Hyperkalemia in Patients Treated with Renin-Angiotensin-Aldosterone System Inhibitors.
    Cardiovasc Drugs Ther 2018 Jan 25. Epub 2018 Jan 25.
    Department of Pharmacology, School of Medicine, Instituto de Investigación Sanitaria Gregorio Marañón, CIBERCV, Universidad Complutense, 28040, Madrid, Spain.
    Hyperkalemia (serum potassium > 5.5 mEq/L) is a common clinical problem in patients with chronic kidney disease, hypertension, diabetes, and heart failure. It can result from increased Kintake, impaired distribution between intracellular and extracellular spaces, and most frequently, decreased renal excretion. Read More

    Plasma Potassium Determines NCC Abundance in Adult Kidney-SpecificENaC Knockout.
    J Am Soc Nephrol 2018 Jan 25. Epub 2018 Jan 25.
    Department of Pharmacology and Toxicology, University of Lausanne, Lausanne, Switzerland;
    The amiloride-sensitive epithelial sodium channel (ENaC) and the thiazide-sensitive sodium chloride cotransporter (NCC) are key regulators of sodium and potassium and colocalize in the late distal convoluted tubule of the kidney. Loss of theENaC subunit leads to a perinatal lethal phenotype characterized by sodium loss and hyperkalemia resembling the human syndrome pseudohypoaldosteronism type 1 (PHA-I). In adulthood, inducible nephron-specific deletion ofENaC in mice mimics the lethal phenotype observed in neonates, and as in humans, this phenotype is prevented by a high sodium (HNa)/low potassium (LK) rescue diet. Read More

    Evaluation of an individualized dose titration regimen of patiromer to prevent hyperkalaemia in patients with heart failure and chronic kidney disease.
    ESC Heart Fail 2018 Jan 25. Epub 2018 Jan 25.
    Department of Internal Medicine, General Hospital Murska Sobota and Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.
    Aims: Hyperkalaemia risk precludes optimal renin-angiotensin-aldosterone system inhibitor use in patients with heart failure (HF), particularly those with chronic kidney disease (CKD). Patiromer is a sodium-free, non-absorbed potassium (K)-binding polymer approved for the treatment of hyperkalaemia. In PEARL-HF, patiromer 25. Read More

    The prevalence of hyperkalemia in the United States.
    Curr Med Res Opin 2018 Jan 25:1-18. Epub 2018 Jan 25.
    a Analysis Group, Inc. , Boston , MA , USA.
    Objective: The retrospective study aimed to estimate prevalence of hyperkalemia using a large US commercial claims database.

    Methods: Adults with serum potassium lab data (2010 to 2014) and ≥1 calendar year of data were included from a large US commercial claims database. Hyperkalemia was defined as ≥2 serum potassium measurements >5. Read More

    Functional plasticity of the gut and the Malpighian tubules underlies cold acclimation and mitigates cold-induced hyperkalemia in.
    J Exp Biol 2018 Jan 24. Epub 2018 Jan 24.
    Department of Biology, York University, Toronto, M3J 1P3, Canada.
    At low temperatures,, like most insects, lose the ability to regulate ion and water balance across the gut epithelia, which can lead to a lethal increase of [K] in the hemolymph (hyperkalemia). Cold-acclimation, the physiological response to a prior low temperature exposure, can mitigate or entirely prevent these ion imbalances, but the physiological mechanisms that facilitate this process are not well understood. Here, we test whether plasticity in the ionoregulatory physiology of the gut and Malpighian tubules ofmay aid in preserving ion homeostasis in the cold. Read More

    Therapeutic Approach to Patients with Heart Failure with Reduced Ejection Fraction and End-stage Renal Disease.
    Curr Cardiol Rev 2018 Jan 23. Epub 2018 Jan 23.
    University of Iowa Hospitals and Clinics, Division of Cardiovascular Diseases 200 Hawkins Dr, Iowa City, IA 52242. United States.
    Several risk factors including Ischemic heart disease, uncontrolled hypertension, high output heart failure (HF) from shunting through vascular hemodialysis access, and anemia, contribute to development of HF in patients with end-stage renal disease (ESRD). Guideline-directed medical and device therapy for Heart Failure with Reduced Ejection Fraction (HFrEF) has not been extensively studied and may have limited safety and efficacy in patients with ESRD. Maintenance of interdialytic and intradialytic euvolemia is a key component of HF management in these patients but often difficult to achieve. Read More

    Safety, Efficacy, and Timeliness of Intravenous Potassium Chloride Replacement Protocols in a Pediatric Cardiothoracic Intensive Care Unit.
    J Intensive Care Med 2018 Jan 1:885066617752659. Epub 2018 Jan 1.
    5 Department of Pediatrics, Cardon Children's Medical Center, Mesa, AZ, USA.
    Objective: Hypokalemia in children following cardiac surgery occurs frequently, placing them at risk of life-threatening arrhythmias. However, renal insufficiency after cardiopulmonary bypass warrants careful administration of potassium (K). Two different nurse-driven protocols (high dose and tiered dosing) were implemented to identify an optimal Kreplacement regimen, compared to an historical low-dose protocol. Read More

    Hepatic portal venous gas due to polystyrene sulfonate-induced enteritis.
    Clin J Gastroenterol 2018 Jan 22. Epub 2018 Jan 22.
    Department of Gastroenterology and Hepatology, Sapporo Medical University School of Medicine, S-1, W-16, Chuo-Ku, Sapporo, 060-8543, Japan.
    A 78-year-old man with acute right lower abdominal pain and nausea was referred to our hospital. Computed tomography (CT) demonstrated hepatic portal venous gas and a thickened wall of the terminal ileum, and colonoscopy demonstrated ulcers and erosions of the ileocecal region. Histological examination of biopsy samples revealed basophilic crystals consistent with the component of calcium polystyrene sulfonate (CPS). Read More

    Sacubitril/valsartan for heart failure with reduced left ventricular ejection fraction : A retrospective cohort study.
    Herz 2018 Jan 19. Epub 2018 Jan 19.
    Mid-German Heart Center, Department of Internal Medicine III, Division of Cardiology, Angiology and Intensive Medical Care, University Hospital Halle, Martin-Luther-University Halle, Ernst Grube-Straße 40, 06120, Halle, Germany.
    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. conventional therapy (ACE inhibitor or angiotensin II receptor blocker added to a beta-blocker plus an MRA) administered to a control group of HFREF patients with comparable clinical features. Read More

    Fludrocortisone-a treatment for tubulopathy post-paediatric renal transplantation: A national paediatric nephrology unit experience.
    Pediatr Transplant 2018 Mar 18;22(2). Epub 2018 Jan 18.
    Department of Paediatric Endocrinology and Diabetes, Royal Hospital for Children, Glasgow, UK.
    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. Read More

    Review of the Diagnostic Evaluation of Normal Anion Gap Metabolic Acidosis.
    Kidney Dis (Basel) 2017 Dec 1;3(4):149-159. Epub 2017 Sep 1.
    St. Elisabeth Hospital, Willemstad, Curaçao.
    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/Naratio is above 0. Read More

    Treatment of Severe Hyperkalemia: Confronting 4 Fallacies.
    Kidney Int Rep 2018 Jan 7;3(1):47-55. Epub 2017 Oct 7.
    Division of Hypertension and Kidney Diseases, Department of Medicine, Rhode Island Hospital and Alpert Medical School of Brown University, Providence, Rhode Island, USA.
    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. Read More

    Acute kidney injury due to multiple Hymenoptera stings-a clinicopathological study.
    Clin Kidney J 2017 Aug 28;10(4):532-538. Epub 2017 Mar 28.
    Community Medicine, Indira Gandhi Medial College, Shimla, Himachal Pradesh, India.
    Background: Acute kidney injury (AKI) after multiple Hymenoptera stings is well known but still a rare phenomenon.

    Methods: We conducted a retrospective study of the clinicopathological spectrum of AKI due to multiple Hymenoptera stings over 13 years (July 2003-June 2016).

    Results: A total of 35 patients were diagnosed with AKI due to multiple Hymenoptera stings. Read More

    Potassium and the use of renin-angiotensin-aldosterone system inhibitors in heart failure with reduced ejection fraction: data from BIOSTAT-CHF.
    Eur J Heart Fail 2018 Jan 12. Epub 2018 Jan 12.
    Department of Cardiology, University of Groningen, Groningen, The Netherlands.
    Background: Hyperkalaemia is a common co-morbidity in patients with heart failure with reduced ejection fraction (HFrEF). Whether it affects the use of renin-angiotensin-aldosterone system inhibitors and thereby negatively impacts outcome is unknown. Therefore, we investigated the association between potassium and uptitration of angiotensin-converting enzyme inhibitors (ACEi)/angiotensin receptor blockers (ARB) and its association with outcome. Read More

    Thyrotoxic Channelopathies.
    J Assoc Physicians India 2017 Nov;65(11):98-99
    Resident Internal Medicine, Manipal Hospitals, Bangalore, Karnataka.
    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. Read More

    The Successful Treatment of Sodium Polystyrene Sulfonate-induced Enteritis Diagnosed by Small Bowel Endoscopy.
    Intern Med 2018 Jan 11. Epub 2018 Jan 11.
    Department of Gastroenterology, Kasugai Municipal Hospital, Japan.
    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. Read More

    Diabetes mellitus and hyperkalemic renal tubular acidosis: case reports and literature review.
    J Bras Nefrol 2017 Oct-Dec;39(4):481-485
    Hospital de Egas Moniz, Centro Hospitalar de Lisboa Ocidental, Lisboa, Portugal.
    Hyporeninemic hypoaldosteronism, despite being common, remains an underdiagnosed entity that is more prevalent in patients with diabetes mellitus. It presents with asymptomatic hyperkalemia along with hyperchloraemic metabolic acidosis without significant renal function impairment. The underlying pathophysiological mechanism is not fully understood, but it is postulated that either aldosterone deficiency (hyporeninemic hypoaldosteronism) and/or target organ aldosterone resistance (pseudohypoaldosteronism) may be responsible. Read More

    A case of tumor lysis syndrome and acute renal failure associated with elotuzumab treatment in multiple myeloma.
    Clin Nephrol Case Stud 2017 22;5:78-81. Epub 2017 Nov 22.
    University of Michigan Health System, Department of Internal Medicine, Division of Nephrology, A. Alfred Taubman Health Care Center, Ann Arbor, MI, USA.
    Renal dysfunction is a common comorbidity of multiple myeloma. However, tumor lysis syndrome is a rare cause of renal dysfunction in multiple myeloma. Elotuzumab is a newly US FDA-approved monoclonal antibody used in the treatment of refractory multiple myeloma. Read More

    Sodium-Reduced Meat and Poultry Products Contain a Significant Amount of Potassium from Food Additives.
    J Acad Nutr Diet 2018 Jan 6. Epub 2018 Jan 6.
    Background: Sodium-reduced packaged food products are increasingly available to consumers; however, it is not clear whether they are suitable for inclusion in a potassium-reduced diet. For individuals with impaired renal potassium excretion caused by chronic kidney disease and for those taking certain medications that interfere with the rennin-angiotensin aldosterone axis, the need to limit dietary potassium is important in view of the risk for development of hyperkalemia and fatal cardiac arrhythmias.

    Objective: The primary objective of this study was to determine the impact of the reduction of sodium in packaged meat and poultry products (MPPs) on the content of potassium and phosphorus from food additives. Read More

    Potassium intake modulates the thiazide-sensitive sodium-chloride cotransporter (NCC) activity via the Kir4.1 potassium channel.
    Kidney Int 2018 Jan 6. Epub 2018 Jan 6.
    Department of Medicine, Oregon Health & Science University, Portland, Oregon, USA. Electronic address:
    Kir4.1 in the distal convoluted tubule plays a key role in sensing plasma potassium and in modulating the thiazide-sensitive sodium-chloride cotransporter (NCC). Here we tested whether dietary potassium intake modulates Kir4. Read More

    Clinical analysis of hyperkalemia after esophagectomy: A case report.
    Medicine (Baltimore) 2017 Dec;96(48):e8966
    Department of Surgical Oncology, Henan Key Laboratory of Cancer Epigenetics, Cancer Institute, The First Affiliated Hospital, College of Clinical Medicine of Henan University of Science and Technology, Luoyang, Henan Province, China.
    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. Read More

    Should we eat more potassium to better control blood pressure in hypertension?
    Nephrol Dial Transplant 2018 Jan 2. Epub 2018 Jan 2.
    Service of Nephrology and Hypertension, Centre Hospitalier Universitaire Vaudois, University Hospital Lausanne, Lausanne, Switzerland.
    Changes in lifestyle and nutrition are recommended as the first-step approach to the management of hypertension by all national and international guidelines. Today, when considering nutritional factors in hypertension, almost all the attention is focused on the reduction of salt intake to improve blood pressure (BP) control. Changes in potassium intake are only briefly evoked in guidelines. Read More

    Adverse Drug Event Monitoring with Clinical and Laboratory Data Using Arden Syntax.
    Stud Health Technol Inform 2017 ;245:1123-1127
    Landesapotheke am St. Johanns-Spital Salzburg, Müllner Hauptstrasse 50, A-5020 Salzburg, Austria.
    In times of steadily increasing numbers of administered drugs, the detection of adverse drug events (ADEs) is an important aspect of improving patient safety. At present only about 1-13% of detected ADEs are reported. Raising the number of reported ADEs will result in greater and more efficient support of pharmacovigilance. Read More

    Recognizing thyrotoxic hypokalemic periodic paralysis.
    JAAPA 2018 Jan;31(1):31-34
    Kamini Patel is on the faculty at the Department of Emergency Medicine at Rutgers-Robert Wood Johnson Medical School in New Brunswick, N.J., and the Department of Emergency Medicine at the Icahn School of Medicine at Mount Sinai, New York, N.Y. Jonathan V. McCoy is an associate professor and research director in the Department of Emergency Medicine at Rutgers-Robert Wood Johnson Medical School. Patrick M. Davis is a clinical instructor in the Department of Emergency Medicine at Rutgers-Robert Wood Johnson Medical School, the Department of Emergency Medicine at New York Institute of Technology's College of Osteopathic Medicine; and the University of New England's College of Osteopathic Medicine in Biddeford, Maine. The authors have disclosed no potential conflicts of interest, financial or otherwise.
    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. Read More

    A Challenging Case of Pseudohyperkalemia in Chronic Lymphocytic Leukemia.
    J Investig Med High Impact Case Rep 2017 Oct-Dec;5(4):2324709617746194. Epub 2017 Dec 13.
    MedStar Washington Hospital Center, Washington, DC, USA.
    Pseudohyperkalemia is an uncommon finding in chronic lymphocytic leukemia. It is a misleading condition that could lead to iatrogenic hypokalemia when unwarranted treatment is administered. We describe an interesting case of pseudohyperkalemia in severe leukocytosis and how we identified it. Read More

    Evaluation of Insulin Use and Hypoglycemia in Hospitalized Elderly Patients.
    Hosp Pharm 2017 Dec 12;52(11):761-765. Epub 2017 Oct 12.
    University of Georgia College of Pharmacy, Albany, GA, USA.
    Routine administration of correctional insulin is no longer recommended as a primary strategy to treat hyperglycemia in hospitalized patients. Studies have demonstrated significant improvement in glycemic control in patients treated with basal and correctional insulin (B+C) versus correctional insulin alone (C). However, the effect of C or B+C on hypoglycemic events is not well understood. Read More

    Revisiting RAAS blockade in CKD with newer potassium-binding drugs.
    Kidney Int 2018 Feb 21;93(2):325-334. Epub 2017 Dec 21.
    Department of Medicine, Indiana University School of Medicine and Richard L. Roudebush Veterans Administration Medical Center, Indianapolis, Indiana, USA. Electronic address:
    Among patients with proteinuric chronic kidney disease (CKD), current guideline recommendations mandate the use of agents blocking the renin angiotensin aldosterone system (RAAS) as first-line antihypertensive therapy based on randomized trials demonstrating that RAAS inhibitors are superior to other antihypertensive drug classes in slowing nephropathy progression to end-stage renal disease. However, the opportunities for adequate RAAS blockade in CKD are often limited, and an important impediment is the risk of hyperkalemia, especially when RAAS inhibitors are used in maximal doses or are combined. Accordingly, a large proportion of patients with proteinuric CKD may not have the anticipated renoprotective benefits since RAAS blockers are often discontinued due to incident hyperkalemia or are administered at suboptimal doses for fear of the development of hyperkalemia. Read More

    Use of Mineralocorticoid Receptor Antagonists in Patients With Heart Failure and Comorbid Diabetes Mellitus or Chronic Kidney Disease.
    J Am Heart Assoc 2017 Dec 23;6(12). Epub 2017 Dec 23.
    Department of Medicine, Duke University School of Medicine, Durham, NC.
    Background: Perceived risks of hyperkalemia and acute renal insufficiency may limit use of mineralocorticoid receptor antagonist (MRA) therapy in patients with heart failure, especially those with diabetes mellitus or chronic kidney disease.

    Methods And Results: Using clinical registry data linked to Medicare claims, we analyzed patients hospitalized with heart failure between 2005 and 2013 with a history of diabetes mellitus or chronic kidney disease. We stratified patients by MRA use at discharge. Read More

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