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    1 OF 179

    Association of Abnormal Serum Potassium Levels with Arrhythmias and Cardiovascular Mortality: a Systematic Review and Meta-Analysis of Observational Studies.
    Cardiovasc Drugs Ther 2018 Apr 20. Epub 2018 Apr 20.
    Network Aging Research, University of Heidelberg, Heidelberg, Germany.
    Purpose: To provide the first systematic review and meta-analysis of observational studies on the association of abnormal serum potassium and cardiovascular outcomes.

    Methods: Medline and ISI Web of Knowledge were systematically searched from inception until November 24, 2017. Data synthesis of relevant studies was performed using random effects model meta-analyses. Read More

    An evidence- and risk-based approach to a harmonized laboratory alert list in Australia and New Zealand.
    Clin Chem Lab Med 2018 Apr 19. Epub 2018 Apr 19.
    NSW Health Pathology, Department of Clinical Chemistry and Endocrinology, Prince of Wales Hospital, Sydney, NSW, Australia.
    Individual laboratories are required to compose an alert list for identifying critical and significant risk results. The high-risk result working party of the Royal College of Pathologists of Australasia (RCPA) and the Australasian Association of Clinical Biochemists (AACB) has developed a risk-based approach for a harmonized alert list for laboratories throughout Australia and New Zealand. The six-step process for alert threshold identification and assessment involves reviewing the literature, rating the available evidence, performing a risk analysis, assessing method transferability, considering workload implications and seeking endorsement from stakeholders. Read More

    Paritaprevir/Ritonavir/Ombitasvir Plus Dasabuvir Regimen in the Treatment of Genotype 1 Chronic Hepatitis C Infection in Patients with Severe Renal Impairment and End-Stage Renal Disease: a Real-Life Cohort.
    Kidney Blood Press Res 2018 Apr 13;43(2):594-605. Epub 2018 Apr 13.
    Department of Hepatogastroenterology, Institute for Clinical and Experimental Medicine, Prague, Czech Republic.
    Background/aims: Chronic hepatitis C (HCV) virus infection reactivates under immunosuppressive drugs and therefore has a negative impact on long-term survival of kidney transplant recipients. Treatment-induced clearance of hepatitis C virus (HCV) in kidney transplant candidates prevents virus reactivation after transplantation. Paritaprevir/Ritonavir/Ombitasvir with Dasabuvir (PrOD) represents a highly effective treatment regimen for HCV genotype 1 (GT1), also suitable for patients with end-stage renal disease (ESRD). Read More

    Role of WNK4 and kidney-specific WNK1 in mediating the effect of high dietary K+ intake on ROMK channel in the distal convoluted tubule.
    Am J Physiol Renal Physiol 2018 Apr 18. Epub 2018 Apr 18.
    Dept of Pharmacology, New York Medical College, United States.
    With-no-lysine kinase 4 (WNK4) and kidney-Specific (KS)-WNK1 regulate ROMK (Kir1.1) channels in a variety of cell models. We now explore the role of WNK4 and KS-WNK1 in regulating ROMK in the native distal convoluted tubule (DCT)/connecting tubule (CNT) by measuring TPNQ (ROMK inhibitor)-sensitive K+ currents with whole-cell recording. Read More

    Incidence, predictors and clinical management of hyperkalaemia in new users of mineralocorticoid receptor antagonists.
    Eur J Heart Fail 2018 Apr 18. Epub 2018 Apr 18.
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Background: Concerns for hyperkalaemia limit the use of mineralocorticoid receptor antagonists (MRAs). The frequency of MRA-associated hyperkalaemia in real-world settings and the extent of subsequent MRA discontinuation are poorly quantified.

    Methods And Results: Observational study including all Stockholm citizens initiating MRA therapy during 2007-2010. Read More

    The tolerability and safety profile of patiromer: a novel polymer-based potassium binder for the treatment of hyperkalemia.
    Expert Opin Drug Saf 2018 Apr 22:1-11. Epub 2018 Apr 22.
    b Medical affairs, Relypsa, Inc. , a Vifor Pharma Group Company , Redwood City , CA , USA.
    Introduction: Hyperkalemia (HK) occurs often among patients with chronic kidney disease (CKD) and heart failure (HF) and those treated with renin-angiotensin-aldosterone system inhibitors (RAASI). Even small deviations from normal potassium levels carry increased risk of mortality. Patiromer is approved for treatment of HK and has been shown in clinical trials to reduce serum potassium among patients with HK and comorbid conditions. Read More

    Racial Differences in Characteristics and Outcomes of Patients With Heart Failure and Preserved Ejection Fraction in the Treatment of Preserved Cardiac Function Heart Failure Trial.
    Circ Heart Fail 2018 Mar;11(3):e004457
    From the Cardiovascular Division, Brigham and Women's Hospital, Boston, MA (E.F.L., B.C., A.M.S., J.L., A.S.D., S.D.S., M.A.P.); Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (S.J.S.); Veterans Affairs Medical Center Minneapolis, Minnesota (I.A.); University of Minnesota Medical School, Minneapolis (I.A.); Veterans Affairs Medical Center at San Diego, CA (I.A.); Montreal Heart Institute, Quebec, Canada (J.L.R., E.O.); Department of Medicine, Sarver Heart Center, University of Arizona, Tucson (N.K.S.); Division of Cardiology, University of Utah, Salt Lake City (J.C.F.); Department of Medicine, Howard University College of Medicine, Washington, DC (T.M.R.); Division of Cardiology, New York Methodist Hospital, Brooklyn (J.F.H.); Division of Cardiology, University of Illinois at Chicago (T.D.S.); National Heart, Lung, and Blood Institute, Bethesda, MD (R.B.); and University of Michigan School of Medicine, Ann Arbor (B.P.).
    Background: Black patients have been shown to have different baseline characteristics and outcomes compared with nonblack patients in cohort studies. However, few studies have focused on heart failure (HF) with preserved ejection fraction (HFpEF) patients. We aimed to determine the difference in cardiovascular outcomes in black and nonblack patients with HFpEF and to determine the relative efficacy and safety of spironolactone in black and nonblack patients. Read More

    Hyporeninemic hypoaldosteronism in a patient with diabetes mellitus: an unforgettable case report.
    Int Med Case Rep J 2018 3;11:69-72. Epub 2018 Apr 3.
    Department of Diabetes & Endocrinology, Peterborough City Hospital, Peterborough, UK.
    A 58-year-old man presented with a 3-year history of chronic and intermittent hyperkalemia requiring recurrent attendances to the emergency department for urgent treatment. His medical history included secondary diabetes mellitus following a bout of acute pancreatitis and a previous splenectomy for a spontaneous splenic rupture. He also had a history of prolonged use of non-steroidal anti-inflammatory drugs for back pain and painful neuropathy. Read More

    Is Transcellular Potassium Shifting With Insulin, Albuterol, or Sodium Bicarbonate in Emergency Department Patients With Hyperkalemia Associated With Recurrent Hyperkalemia After Dialysis?
    J Emerg Med 2018 Apr 13. Epub 2018 Apr 13.
    Department of Emergency Medicine, Hennepin County Medical Center, Minneapolis, Minnesota; Department of Internal Medicine, Hennepin County Medical Center, Minneapolis, Minnesota.
    Background: Emergency department (ED) treatment of hyperkalemia often involves shifting potassium into the intracellular space. There is uncertainty whether transcellular shifting causes insufficient potassium removal during hemodialysis, resulting in a subsequent need for further medical therapy or multiple sessions of hemodialysis.

    Objective: We sought to determine whether transcellular potassium shifting in ED patients with hyperkalemia who undergo hemodialysis is associated with recurrent hyperkalemia with or without repeat hemodialysis within 24 h. Read More

    Clinical findings and diagnostic procedures in 270 small ruminants with obstructive urolithiasis.
    J Vet Intern Med 2018 Apr 16. Epub 2018 Apr 16.
    Clinic for Ruminants, Vetsuisse Faculty, University of Bern, Bremgartenstrasse 109a, Bern 3012, Switzerland.
    Background: Details of the clinical signs of obstructive urolithiasis in male small ruminants have not been documented in a large population.

    Objective: To describe the clinical presentation and diagnostic procedures in a large group of small ruminants with urolithiasis.

    Animals: Two hundred and seventy small ruminants (158 sheep and 112 goats). Read More

    Rationale and design of the comParIson Of sacubitril/valsartaN versus Enalapril on Effect on nt-pRo-bnp in patients stabilized from an acute Heart Failure episode (PIONEER-HF) trial.
    Am Heart J 2018 Apr 10;198:145-151. Epub 2018 Jan 10.
    Thrombolysis in Myocardial Infarction (TIMI) Study Group, Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
    Objective: The objective is to assess the safety, tolerability, and efficacy of sacubitril/valsartan compared with enalapril in patients with heart failure (HF) with a reduced ejection fraction (EF) stabilized during hospitalization for acute decompensated HF.

    Background: Sacubitril/valsartan, a first-in-class angiotensin receptor-neprilysin inhibitor, improves survival among ambulatory HF patients with a reduced EF. However, there is very limited experience with the in-hospital initiation of sacubitril/valsartan in patients who have been stabilized following hospitalization for acute decompensated HF. Read More

    An Evaluation of the Pharmacodynamics, Safety, and Tolerability of the Potassium Binder RDX7675.
    J Clin Pharmacol 2018 Apr 12. Epub 2018 Apr 12.
    Ardelyx, Inc., Fremont, CA, USA.
    Hyperkalemia is common in patients with heart failure or chronic kidney disease, particularly those taking renin-angiotensin-aldosterone system inhibitors, and can cause arrhythmias and sudden cardiac death. The most widely used treatment, sodium polystyrene sulfonate (SPS), limits gastrointestinal potassium absorption, but has poor palatability. RDX7675 (RDX227675) is the calcium salt of a reengineered polystyrene sulfonate-based resin with improved palatability over SPS. Read More

    Pretreatment of enteral nutrition with sodium polystyrene sulfonate: effective, but beware the high prevalence of electrolyte derangements in clinical practice.
    Clin Kidney J 2018 Apr 21;11(2):166-171. Epub 2017 Dec 21.
    Division of Nephrology, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
    Background: Current treatment options for chronic hyperkalemia in children with chronic kidney disease include dietary restrictions or enteral sodium polystyrene sulfonate (SPS); however, dietary restrictions may compromise adequate nutrition and enteral SPS may be limited by palatability, adverse effects and feeding tube obstruction. A potentially safer alternative is to pretreat enteral nutrition (EN) with SPS prior to consumption. The purpose of this study was to evaluate the efficacy and safety of pretreating EN with SPS in pediatric patients with hyperkalemia. Read More

    The dialysis orders objective structured clinical examination (OSCE): a formative assessment for nephrology fellows.
    Clin Kidney J 2018 Apr 23;11(2):149-155. Epub 2017 Aug 23.
    Nephrology Division, Walter Reed National Military Medical Center, Bethesda, MD, USA.
    Background: Few quantitative nephrology-specific simulations assess fellow competency. We describe the development and initial validation of a formative objective structured clinical examination (OSCE) assessing fellow competence in ordering acute dialysis.

    Methods: The three test scenarios were acute continuous renal replacement therapy, chronic dialysis initiation in moderate uremia and acute dialysis in end-stage renal disease-associated hyperkalemia. Read More

    Evaluation of Appropriate Sodium Polystyrene Sulfonate Use With a Hyperkalemia Order Set: A Pilot Study.
    J Pharm Pract 2018 Jan 1:897190018767685. Epub 2018 Jan 1.
    2 Internal Medicine, Mercy Hospital St. Louis, St. Louis College of Pharmacy, St. Louis, MO, USA.
    Background: No consensus guidelines exist to assist practitioners in the management of hyperkalemia. Sodium polystyrene sulfonate (SPS) is a common treatment option for hyperkalemia. To aid health-care professionals, a hyperkalemia order set was created at a 979-bed community teaching hospital. Read More

    Spontaneous conversion of atrial fibrillation caused by severe hyperkalemia: A case report.
    Medicine (Baltimore) 2018 Apr;97(15):e0442
    Department of Cardiology, the First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, P.R. China.
    Rationale: Hyperkalemia is a life-threatening electrolyte disturbance which could lead to arrhythmias and potentially death.

    Patient Concerns: An 82-year-old male patient who presented typical electrocardiographic indications of hyperkalemia, including the absence of P waves, prolongation of QRS complex, sinoventricular conduction, bradyarrhythmia and tall peaked T waves. He developed a rare self-defibrillation of atrial fibrillation to sinus rhythm due to hyperkalemia. Read More

    A First-in-Human Phase 1 Study of LY3023414, an Oral PI3K/mTOR Dual Inhibitor, in Patients with Advanced Cancer.
    Clin Cancer Res 2018 Apr 10. Epub 2018 Apr 10.
    OB/GYN, University of Oklahoma.
    Purpose: The phosphatidylinositol 3-kinase (PI3K)/mammalian target of rapamycin (mTOR) pathway is frequently aberrated in cancer. LY3023414 is a potent and selective ATP competitive inhibitor of class I PI3K isoforms, mTOR, and DNA-PK. Here we report the dose escalation results of the first-in-human phase I study of LY3023414. Read More

    Haste makes waste-Should current guideline recommendations for initiation of renal replacement therapy for acute kidney injury be changed?
    Semin Dial 2018 Apr 10. Epub 2018 Apr 10.
    Renal Division, Department of Medicine, Ghent University Hospital, Ghent, Belgium.
    There is broad consensus among guideline organizations that renal replacement therapy (RRT) should not be delayed in case of life-threatening conditions. However, in case of severe acute kidney injury (AKI) without these conditions, it is unclear whether immediate RRT has an advantage over delayed RRT. Two recently published randomized controlled trials (AKIKI and ELAIN) with seemingly opposite results have reignited the discussion whether guideline recommendations on initiation strategies in severe AKI should be adapted. Read More

    Continuous Veno-Venous Hemofiltration During Intercontinental Aeromedical Evacuation.
    Mil Med 2018 Mar;183(suppl_1):189-192
    U.S. Army Institute of Surgical Research, 3698 Chambers Pass, Fort Sam Houston, TX 78234.
    Overseas contingency operations which occur in areas lacking medical infrastructure pose challenges to the stabilization and transportation of critically ill patients. In particular, metabolic derangements resulting from acute kidney injury (AKI) make long-distance aeromedical evacuation risky. Here, we report the first modern use of in-flight continuous veno-venous hemofiltration (CVVH) for intercontinental aeromedical evacuation. Read More

    Combined effect of renal function and serum potassium level in sudden cardiac death in aging hypertensive subjects.
    Hypertens Res 2018 Apr 9. Epub 2018 Apr 9.
    Pharmacie, Hospices Civils de Lyon- EMR3738 Ciblage thérapeutique en oncologie, Université C Bernard Lyon 1, Lyon, France.
    In patients with chronic kidney disease, serum potassium level is a factor influencing sudden cardiac death (SCD). The aim of our analysis was to study the combined effect of serum potassium level and renal function on the onset of SCD in elderly hypertensive subjects. Data from the 3620 hypertensive patients aged over 70 years were extracted from three randomized clinical trials included in the INDANA database. Read More

    Immune complex glomerulonephritis of suspected iatrogenic origin in five Japanese Black calves.
    J Vet Med Sci 2018 Apr 6. Epub 2018 Apr 6.
    Department of Veterinary Medicine and Surgery, University of Missouri, College of Veterinary Medicine.
    Five Japanese Black embryo transfer calves from a single embryo flush, 30 to 45-days-old, including 4 live animals for clinical examination and 1 dead for necropsy, were presented with a history of decreased milk intake and hypoproteinemia. Consistent clinicopathological abnormalities in the 4 calves presented for clinical evaluation included hyperkalemia, hyperphosphatemia, hypoproteinemia, hypoalbuminemia, hyperbilirubinemia, increased creatine phosphokinase activity, and proteinuria. Four calves ultimately were necropsied and all had histologic evidence of immune complex glomerulonephritis. Read More

    New-onset insulin-dependent diabetes due to nivolumab.
    Endocrinol Diabetes Metab Case Rep 2018 28;2018. Epub 2018 Mar 28.
    Divisions of Pulmonary and Critical Care Medicine, Mayo Clinic, Jacksonville, Florida, USA.
    Nivolumab, a monoclonal antibody against programmed cell death-1 receptor, is increasingly used in advanced cancers. While nivolumab use enhances cancer therapy, it is associated with increased immune-related adverse events. We describe an elderly man who presented in ketoacidosis after receiving nivolumab for metastatic renal cell carcinoma. Read More

    [Recognizing rare cardiac diseases by electrocardiogram].
    Internist (Berl) 2018 Apr 4. Epub 2018 Apr 4.
    Abteilung für Elektrophysiologie, Herzzentrum Leipzig, Leipzig, Deutschland.
    A number of rare cardiac diseases can be recognized by electrocardiogram (ECG). This article illustrates the clinical importance of ECG as a key diagnostic tool to detect Wolff-Parkinson-White syndrome and channelopathies, which are frequently diagnosed late after one or more affected family members have become victims of sudden cardiac death. These channelopathies include long QT syndrome, short QT syndrome, Brugada syndrome, and catecholaminergic polymorphic ventricular tachycardia. Read More

    Critically Elevated Potassium in a 55-Year-Old Female With Chronic Lymphocytic Leukemia.
    Lab Med 2018 Mar 28. Epub 2018 Mar 28.
    Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN.
    Hyperkalemia in specimens from patients with chronic lymphocytic leukemia (CLL) may be due to tumor lysis syndrome (TLS) or specimen processing. This report describes a 55-year-old Caucasian woman with CLL who presented to an outside hospital with hyperkalemia and was transferred to a second hospital. Initial evaluation on the core laboratory chemistry analyzer (the VITROS 5600) and the ABL90 FLEX blood gas analyzer showed markedly elevated levels of potassium (K+). Read More

    [Cardio-renal axis : Relationship of heart failure and renal insufficiency as comorbidities].
    Internist (Berl) 2018 Mar 28. Epub 2018 Mar 28.
    Klinik für Nephrologie und Rheumatologie, Universitätsmedizin Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Deutschland.
    Heart failure and kidney dysfunction are common comorbidities with overlapping and synergizing mechanisms. Coincidence of both pathologies aggravates disease progression rates, symptoms, and outcomes. The treatment of patients with advanced renal insufficiency is faced with limited evidence for therapies that are standard of care in patients with normal and moderate kidney failure, frequent deterioration of kidney function during therapy, and onset of hyperkalemia, which pose challenges for clinical care, requiring intensified physician-patient contacts. Read More

    Review of case reports on hyperkalemia induced by dietary intake: not restricted to chronic kidney disease patients.
    Eur J Clin Nutr 2018 Mar 27. Epub 2018 Mar 27.
    Department of Medical Physiology, Division of Heart & Lungs, University Medical Center Utrecht, Yalelaan 50, 3584 CM, Utrecht, The Netherlands.
    Hyperkalemia is a metabolic disturbance of the potassium balance that can cause potentially fatal cardiac arrhythmias. Kidney dysfunction and renin-angiotensin-aldosterone system inhibiting drugs are notorious for their tendency to induce hyperkalemia by decreasing the excretion of potassium. The role of dietary potassium intake in inducing hyperkalemia is less clear. Read More

    Spironolactone to increase natriuresis in congestive heart failure with cardiorenal syndrome.
    Acta Cardiol 2018 Mar 27:1-8. Epub 2018 Mar 27.
    a Department of Cardiology , Ziekenhuis Oost-Limburg , Genk , Belgium.
    Background: Signs and symptoms of volume overload are the most frequent reason for hospital admission in acute heart failure (AHF). Diuretics are mainstay treatment, but their optimal type and dose regimen remain unclear, especially in patients with cardiorenal syndrome.

    Methods: This prospective study aimed to include 80 AHF patients with volume overload and cardiorenal syndrome. Read More

    Molecular genetic studies in a case series of isolated hypoaldosteronism due to biosynthesis defects or aldosterone resistance.
    Clin Endocrinol (Oxf) 2018 Mar 27. Epub 2018 Mar 27.
    Faculty of Medicine, Division of Pediatric Endocrinology, Cukurova University, Adana, Turkey.
    Background And Aim: Hypoaldosteronism is associated with either insufficient aldosterone production or aldosterone resistance (pseudohypoaldosteronism). Patients with aldosterone defects typically present with similar symptoms and findings, which include failure to thrive, vomiting, hyponatremia, hyperkalemia and metabolic acidosis. Accurate diagnosis of these clinical conditions therefore can be challenging. Read More

    Influence of Proportion of Normal Saline Administered in the Perioperative Period of Renal Transplantation on Kalemia Levels.
    Transplant Proc 2018 Mar;50(2):569-571
    Public Health Department, Facultad de Medicina, Universidad de Cantabria, Cantabria, Spain.
    Background: The hyperchloremic metabolic acidosis triggered by the infusion of normal saline (NS) significantly increases the level of extracellular potassium. In this study we assessed the influence of proportion of NS administered in the perioperative period of renal transplantation on potassium levels in usual clinical practice.

    Methods: This study was a retrospective cohort analysis of patients undergoing renal transplantation during a 24-month period (2015-2016). Read More

    Comparative efficacy of individual renin-angiotensin system inhibitors on major renal outcomes in diabetic kidney disease: a network meta-analysis.
    Nephrol Dial Transplant 2018 Mar 22. Epub 2018 Mar 22.
    Department of respiratory medicine, Zhangjiajie City Hospital, Zhangjiajie, Hunan, China.
    Background: Angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) are two drug classes with well-documented renal protective effects. However, whether there is any difference among individual drugs remains unknown. In this study, we aimed to compare the efficacy of individual ACEIs/ARBs on major renal outcomes in adults with diabetic kidney disease (DKD). Read More

    Factors associated with underuse of mineralocorticoid receptor antagonists in heart failure with reduced ejection fraction: an analysis of 11 215 patients from the Swedish Heart Failure Registry.
    Eur J Heart Fail 2018 Mar 26. Epub 2018 Mar 26.
    Division of Cardiology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden.
    Aim: Mineralocorticoid receptor antagonists (MRAs) improve outcomes in heart failure with reduced ejection fraction (HFrEF), but are underutilized. Hyperkalaemia may be one reason, but the underlying reasons for underuse are unknown. The aim of this study was to investigate the independent predictors of MRA underuse in a large and unselected HFrEF cohort. Read More

    Medical Management of Endocarditis Caused by Stenotrophomonas maltophilia: A Case Report.
    J Pharm Pract 2018 Jan 1:897190018764957. Epub 2018 Jan 1.
    3 Department of Pharmacy, Cooper University Hospital, Camden, NJ, USA.
    A 44-year-old female was found to be systemically ill at dialysis and admitted to the hospital. Days into the hospitalization, her blood cultures from dialysis were positive with Stenotrophomonas maltophilia bacteremia with a levofloxacin minimum inhibitory concentration (MIC) of 1. She was discharged on ciprofloxacin 500 mg orally (PO) daily on hospital day 2 to complete a 14-day course. Read More

    Beyond the limits - ECPR in putative fatal circumstances.
    CJEM 2018 Mar 25:1-4. Epub 2018 Mar 25.
    †Department of Anaesthesiology and Intensive Care Medicine,University Hospital Bonn,Bonn,Germany.
    The eligibility criteria for applying extracorporeal cardiopulmonary resuscitation (ECPR) in patients with cardiac arrest are currently unclear. For those patients with hypothermic cardiac arrest, the European Resuscitation Council (ERC) Guidelines recommend considering ECPR only for patients with potassium <8 mmol/L and a body temperature below 32°C, whereas the American Heart Association Guidelines (AHA) do not express this in a specific manner. We report the case of an urban unwitnessed out-of-hospital cardiac arrest patient found with her head immersed in water at a temperature of 23°C. Read More

    Incident Hyperkalemia, Hypokalemia, and Clinical Outcomes during Spironolactone Treatment of Heart Failure with Preserved Ejection Fraction: Analysis of the TOPCAT Trial.
    J Card Fail 2018 Mar 20. Epub 2018 Mar 20.
    Cardiovascular Division, University of Michigan School of Medicine, Ann Arbor, MI.
    Background: In patients with heart failure and preserved ejection fraction (HF-PEF) randomized in the Americas (but not Russia and Georgia) as part of the TOPCAT trial, treatment with spironolactone enhanced the risk of hyperkalemia but reduced the risk of hypokalemia. We examined the clinical correlates and prognostic implications of incident hypo- and hyperkalemia during study follow up.

    Methods: We defined the region-specific incidence of hypokalemia (potassium [K]<3. Read More

    Moderate glucose supply reduces hemolysis during systemic inflammation.
    J Inflamm Res 2018 12;11:87-94. Epub 2018 Mar 12.
    Institute of Physiological Chemistry, University Hospital Essen, Essen, Germany.
    Background: Systemic inflammation alters energy metabolism. A sufficient glucose level, however, is most important for erythrocytes, since erythrocytes rely on glucose as sole source of energy. Damage to erythrocytes leads to hemolysis. Read More

    Acute diffuse alveolar haemorrhage accompanied by gastrointestinal bleeding in a patient with serious systemic lupus erythematosus: A case report.
    J Int Med Res 2018 Jan 1:300060517749666. Epub 2018 Jan 1.
    4 Department of Rheumatology and Immunology, 74678 Zhejiang Provincial People's Hospital , People's Hospital of Hangzhou Medical College, Hangzhou, China.
    Systemic lupus erythematosus (SLE) is an autoimmune disease that affects many organs, but multisystem dysfunction is rare. Here, we report a case of a 29-year-old woman who was initially diagnosed with SLE complications including lupus nephritis, lupus encephalopathy, renal hypertension, thrombocytopenia, anaemia and hyperkalaemia. She recovered following treatment with high dose methylprednisolone, intravenous immunoglobulin (IVIG) and continuous renal replacement therapy (CRRT). Read More

    Serum potassium and adverse outcomes across the range of kidney function: a CKD Prognosis Consortium meta-analysis.
    Eur Heart J 2018 Mar 14. Epub 2018 Mar 14.
    Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 2024 E. Monument Street, Baltimore, MD 21205, USA.
    Aims: Both hypo- and hyperkalaemia can have immediate deleterious physiological effects, and less is known about long-term risks. The objective was to determine the risks of all-cause mortality, cardiovascular mortality, and end-stage renal disease associated with potassium levels across the range of kidney function and evaluate for consistency across cohorts in a global consortium.

    Methods And Results: We performed an individual-level data meta-analysis of 27 international cohorts [10 general population, 7 high cardiovascular risk, and 10 chronic kidney disease (CKD)] in the CKD Prognosis Consortium. Read More

    Assessing the Impact of an Order Panel Utilizing Weight-Based Insulin and Standardized Monitoring of Blood Glucose for Patients With Hyperkalemia.
    Am J Med Qual 2018 Mar 1:1062860618764610. Epub 2018 Mar 1.
    1 Duke University Medical Center, Durham, NC.
    Intravenous insulin with glucose is used in urgent treatment for hyperkalemia but has a significant risk of hypoglycemia. The authors developed an order panel within the electronic health record system that utilizes weight-based insulin dosing and standardized blood glucose monitoring to reduce hypoglycemia. As initial evaluation of this protocol, the authors retrospectively compared potassium and blood glucose lowering in patients treated with the weight-based (0. Read More

    Brugada Phenocopy induced by recurrent hyperkalemia: More evidence for the reproducibility of a new phenomenon.
    J Electrocardiol 2018 Mar 7. Epub 2018 Mar 7.
    Cardiology, Onofre Lopes University Hospital-Faculty of Medicine, Universidade Federal do Rio Grande do Norte (UFRN), Natal, Brazil.

    Assessing Guideline-Directed Medication Therapy for Heart Failure in End-Stage Renal Disease.
    Am J Med Sci 2018 Mar 21;355(3):247-251. Epub 2017 Nov 21.
    Department of Clinical Pharmacy and Translational Science, The University of Tennessee College of Pharmacy, Memphis, TN; Department of Medicine (Nephrology), The University of Tennessee, Memphis, TN. Electronic address:
    Background: Treatment of heart failure with reduced ejection fraction (HFrEF) requires guideline-directed medication therapy (GDMT) consisting of either an angiotensin-converting enzyme inhibitor or an angiotensin receptor blocker in combination with an indicated beta-blocker. There is concern that end-stage renal disease (ESRD) patients are not being prescribed GDMT. The study aim was to determine whether outcomes differ for patients with HFrEF and ESRD receiving GDMT compared to those not receiving GDMT. Read More

    Clinical predictor of postoperative hyperkalemia after parathyroidectomy in patients with hemodialysis.
    Int J Surg 2018 Mar 13;53:1-4. Epub 2018 Mar 13.
    Department of Otolaryngology, Guangdong General Hospital and Guangdong Academy of Medical Sciences, Guangzhou City, PR China.
    Objective: Hyperkalaemia is one of the most common reasons for patients requiring emergency treatment. This study is to investigate the risk factors of postoperative hyperkalemia in renal failure patients undergoing parathyroidectomy with autotransplantation (PTXa).

    Methods: One hundred and eight patients [ 54 men and 54 women; age, 45. Read More

    Management of tumour lysis syndrome during first-line palliative chemotherapy for high-volume colorectal cancer.
    BMJ Case Rep 2018 Mar 15;2018. Epub 2018 Mar 15.
    Medical Oncology Department, Centro Hospitalar de Entre Douro e Vouga, EPE, Santa Maria da Feira, Portugal.
    Tumour lysis syndrome (TLS) is a rare oncological emergency in solid tumours. Because it is associated with bad short-term prognosis, early recognition and treatment are mandatory. This case refers to a middle-aged woman who presented with stage IV colon cancer, with massive hepatic involvement. Read More

    Electrolyte Abnormalities in Neonates with Probable and Culture-Proven Sepsis and its Association with Neonatal Mortality.
    J Coll Physicians Surg Pak 2018 03;28(3):206-209
    Department of Pediatrics, Fazle Omar Hospital, Chenab Nagar, Rabwah, Pakistan.
    Objective: To ascertain the frequency of electrolyte abnormalities in patients of probable and culture-proven sepsis on admission and assess any association of electrolyte disorders with mortality.

    Study Design: Descriptive study.

    Place And Duration Of Study: NICU, Fazle-Omar Hospital, Rabwah, from October 2015 to September 2016. Read More

    Beta-blockers do not protect against cardiac toxicity of hyperkalemia : Response to the article by Legrand et al. 'Association between hypo- and hyperkalemia and outcome in acute heart failure patients: the role of medications' [1].
    Clin Res Cardiol 2018 Mar 12. Epub 2018 Mar 12.
    Department of Anaesthesiology and Cardiovascular/Surgical Intensive Care Unit, Groupe Hospitalier Bichat Claude Bernard, HUPNVS, Assistance Publique Hôpitaux de Paris, Paris, France.

    Rare Cause of Hyperkalemia in the Newborn Period: Report of Two Cases of Pseudohypoaldosteronism Type 1.
    Indian J Nephrol 2018 Jan-Feb;28(1):69-72
    Department of Neonatology, Sri Ramachandra Medical University, Chennai, Tamil Nadu, India.
    Pseudohypoaldosteronism (PHA) Type 1 is characterized by mineralocorticoid resistance, manifesting as neonatal salt wasting, hypotension, hyperkalemia, hyponatremia, and metabolic acidosis in spite of elevated aldosterone levels and plasma renin activity. It is important to differentiate children with systemic PHA from renal PHA, as these children are likely to decompensate even with mild symptoms. Here, we report two neonates with PHA that presented to us with multiorgan involvement. Read More

    A case of an infant suspected as IMAGE syndrome who were finally diagnosed with MIRAGE syndrome by targeted Mendelian exome sequencing.
    BMC Med Genet 2018 Mar 5;19(1):35. Epub 2018 Mar 5.
    Department of Pediatrics, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-Gu, Seoul, 05505, South Korea.
    Background: Adrenal hypoplasia is a rare congenital disorder, which can be classified into a non-syndromic form, without extra-adrenal features, and a syndromic form, with such features. Despite biochemical and molecular genetic evaluation, etiologic diagnosis cannot be performed in many patients with adrenal hypoplasia.

    Case Presentation: The patient in this case was a boy born at 31 weeks of gestation with a weight of 882 g (< 3rd percentile) to non-consanguineous parents. Read More

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