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    8631 results match your criteria Hyperkalemia

    1 OF 173

    Impact of Renin-Angiotensin Aldosterone System Inhibition on Serum Potassium Levels among Peritoneal Dialysis Patients.
    Am J Nephrol 2017 Jul 22;46(2):150-155. Epub 2017 Jul 22.
    Background: The chronic use of angiotensin-converting enzyme inhibitors or angiotensin II receptor blocker has been associated with hyperkalemia in patients with reduced renal function even after the initiation of hemodialysis. Whether such medications may cause a similar effect in peritoneal dialysis patients is not well established. So, the aim of our study was to analyze the impact of renin-angiotensin-aldosterone inhibitors on the serum levels of potassium in a national cohort of peritoneal dialysis patients. Read More

    Incidence and determinants of hyperkalemia and hypokalemia in a large healthcare system.
    Int J Cardiol 2017 Jul 15. Epub 2017 Jul 15.
    Department of Medical Epidemiology and Biostatistics (MEB), Karolinska Institutet, Sweden. Electronic address:
    Background: Hypo- and hyperkalemia in clinical settings are insufficiently characterized and large-scale data from Europe lacking. We studied incidence and determinants of these abnormalities in a large Swedish healthcare system.

    Methods: Observational study from the Stockholm CREAtinine Measurements project, including adult individuals from Stockholm accessing healthcare in 2009 (n=364,955). Read More

    Fluids in Sepsis and Septic Shock (FISSH): protocol for a pilot randomised controlled trial.
    BMJ Open 2017 Jul 20;7(7):e017602. Epub 2017 Jul 20.
    Department of Medicine, Division of Critical Care, McMaster University, Hamilton, Ontario, Canada.
    Introduction: Observational evidence suggests physiological benefits and lower mortality with lower chloride solutions; however, 0.9% saline remains the most widely used fluid worldwide. Given uncertainty regarding the association of lower chloride on mortality, it is unlikely that practice will change without direct randomised clinical trial (RCT) evidence. Read More

    Hyperkalemia After Initiating Renin-Angiotensin System Blockade: The Stockholm Creatinine Measurements (SCREAM) Project.
    J Am Heart Assoc 2017 Jul 19;6(7). Epub 2017 Jul 19.
    Division of Nephrology, Department of Medicine, Johns Hopkins University, Baltimore, MD
    Background: Concerns about hyperkalemia limit the use of angiotensin-converting enzyme inhibitors (ACE-I) and angiotensin receptor blockers (ARBs), but guidelines conflict regarding potassium-monitoring protocols. We quantified hyperkalemia monitoring and risks after ACE-I/ARB initiation and developed and validated a hyperkalemia susceptibility score.

    Methods And Results: We evaluated 69 426 new users of ACE-I/ARB therapy in the Stockholm Creatinine Measurements (SCREAM) project with medication initiation from January 1, 2007 to December 31, 2010, and follow-up for 1 year thereafter. Read More

    Two Catastrophes in One Patient: Drug Reaction with Eosinophilia and Systemic Symptoms and Toxic Shock Syndrome.
    Cureus 2017 Jun 15;9(6):e1359. Epub 2017 Jun 15.
    Internal Medicine, Quillen College of Medicine at East Tennessee State University.
    A 70-year-old, immunocompromised patient presented to the emergency room (ER) five weeks after she was started on clopidogrel. She complained of skin eruption, mouth ulcers, fatigue, and myalgia over the past two weeks. Labs showed severe hyponatremia, acute kidney injury, rhabdomyolysis, hyperkalemia, and elevated liver enzymes. Read More

    A retrospective study of emergency department potassium disturbances: severity, treatment, and outcomes.
    Clin Exp Emerg Med 2017 Jun 30;4(2):73-79. Epub 2017 Jun 30.
    Department of Emergency Medicine, Baylor College of Medicine, Houston, TX, USA.
    Objective: Disturbances in potassium (K) levels are relatively common and may be associated with significant morbidity and mortality; however, treatments vary. Our purpose was to determine the incidence, treatments, and outcomes associated with hyperkalemia and hypokalemia in emergency department (ED) patients.

    Methods: We performed a structured, retrospective review of electronic medical records of consecutive adult ED patients with K measured while in the ED. Read More

    Aldosterone antagonist therapy and its relationship with inflammation, fibrosis, thrombosis, mineral-bone disorder and cardiovascular complications in peritoneal dialysis (PD) patients.
    Int Urol Nephrol 2017 Jul 14. Epub 2017 Jul 14.
    Department of Nephrology, Hypertension and Internal Medicine, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University Toruń, Toruń, Poland.
    Background: High aldosterone level may contribute to pathogenesis of hypertension, vessels damage and cardiovascular system deterioration in chronic kidney disease patients. Besides its classical action via mineralocorticoid receptor, aldosterone is also involved in cell growth, inflammation, oxidative stress, endothelial dysfunction and exerts fibroproliferative effects. The aim of the study was to assess whether aldosterone antagonist treatment may influence serum level of inflammatory, fibrosis, thrombosis and mineral-bone metabolism markers in peritoneal dialysis (PD) patients and blood pressure, aortic stiffness, echocardiographic indices after 12 months of treatment. Read More

    Complement factor B mutation-associated aHUS and myocardial infarction.
    BMJ Case Rep 2017 Jul 14;2017. Epub 2017 Jul 14.
    Serviáo de Cuidados Intensivos Pediátricos, Hospital Pediátrico, Centro Hospitalar e Universitário de Coimbra, Portugal.
    A 6-month-old female infant was referred with a 3-day history of low-grade fever, slight nasal congestion and rhinorrhoea. On admission, the clinical findings were unremarkable and she was discharged home. However, she became progressively more listless with a decreased urine output and was once again seen in the emergency department. Read More

    Impact of Hyperkalemia and Worsening Renal Function on the Use of Renin Angiotensin Aldosterone System Inhibitors in Chronic Heart Failure With Reduced Ejection Fraction.
    Clin Pharmacol Ther 2017 Jul 14. Epub 2017 Jul 14.
    Inserm, Centre d'Investigations Cliniques-Plurithématique 14-33, Inserm U1116, CHRU, Nancy, Université de Lorraine, and F-CRIN INI-CRCT (Cardiovascular and Renal Clinical Trialists), Nancy, France.
    Patients with heart failure (HF) and reduced ejection fraction (HFREF) are at increased risk of death and hospitalizations for HF. Numerous registries have reported a large and persistent gap between real-life practice in the use of life-saving evidence-based therapies, such as renin angiotensin system inhibitors, beta blockers, mineralocorticoid receptor antagonists (MRAs), and recommended practices in international guidelines. The fears of inducing hyperkalemia and/or worsening renal function are the main triggers of this underuse. Read More

    Ramipril-associated cholestasis in the setting of recurrent drug-induced liver injury.
    Gastroenterol Hepatol Bed Bench 2017 ;10(2):143-146
    Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.
    Aim: Angiotensin-converting enzyme inhibitors (ACEIs) are commonly used to treat hypertension. Although generally well tolerated, the adverse effects of ACEIs include hypotension, cough, acute kidney injury and hyperkalemia. Rare reports of ACEI-induced hepatotoxicity have been described, most notably a cholestatic pattern of injury related to captopril. Read More

    Efficacy and Safety of Spironolactone in Acute Heart Failure: The ATHENA-HF Randomized Clinical Trial.
    JAMA Cardiol 2017 Jul 12. Epub 2017 Jul 12.
    Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
    Importance: Persistent congestion is associated with worse outcomes in acute heart failure (AHF). Mineralocorticoid receptor antagonists administered at high doses may relieve congestion, overcome diuretic resistance, and mitigate the effects of adverse neurohormonal activation in AHF.

    Objective: To assess the effect of high-dose spironolactone and usual care on N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels compared with usual care alone. Read More

    Electrolyte and Acid-Base Abnormalities in Infants with Community-Acquired Acute Pyelonephritis: Prospective Cross-Sectional Study.
    Nephron 2017 Jul 12. Epub 2017 Jul 12.
    Pediatric Unit, Department of Clinical Sciences and Community Health, Ospedale Maggiore Policlinico, Università Degli Studi di Milano, Milan, Italy.
    Background: Retrospective case series suggest that abnormalities in fluid, electrolyte, and acid-base homeostasis may occur among infants with a febrile urinary tract infection. Potentially inaccurate laboratory methods of sodium testing have often been used.

    Methods: Between January 2009 and June 2016, we managed 80 previously healthy infants (52 males and 28 females) ≥4 weeks to ≤24 months of age with their first episode of acute pyelonephritis. Read More

    The impact of hypothermia on serum potassium concentration: A systematic review.
    Resuscitation 2017 Jul 5;118:35-42. Epub 2017 Jul 5.
    Department of Emergency Medicine, SAMU 38, University Hospital of Grenoble Alps, Grenoble, France. Electronic address:
    Background: Blood potassium is the main prognostic biomarker used for triage in hypothermic cardiac arrest. The aim of this review was to assess the impact of hypothermia on blood potassium levels and compare the underlying pathophysiological theories.

    Methods: The Medline electronic database was searched via PubMed for articles published from January 1970 to December 2016. Read More

    The Impact of Serum Potassium-Influencing Antihypertensive Drugs on the Risk of Out-of-Hospital Cardiac Arrest: A Case Control Study.
    Br J Clin Pharmacol 2017 Jun 29. Epub 2017 Jun 29.
    Department of Cardiology, Heart Center, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
    Background: Sudden cardiac arrest (SCA) is a complex multifactorial event and most commonly caused by ventricular tachycardia/ fibrillation (VT/ VF). Some antihypertensive drugs could induce hypokalaemia or hyperkalaemia that may increase susceptibility to VT/VF and SCA.

    Objective: To assess the association between different classes of antihypertensive drugs classified according to their potential impact on serum potassium levels and the occurrence of out-of-hospital cardiac arrest (OHCA) based on VT/VF. Read More

    Treatment of Hyperkalemia in Heart Failure.
    Curr Heart Fail Rep 2017 Jun 27. Epub 2017 Jun 27.
    Cardiovascular Division (ASD) and Department of Medicine (EMD, ASD), Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
    Purpose Of Review: The aim of this paper is to discuss strategies for prevention and management of hyperkalemia in patients with heart failure, including the role of novel therapies.

    Recent Findings: Renin-angiotensin-aldosterone system (RAAS) antagonists, including angiotensin-converting enzyme inhibitors (ACEI), angiotensin receptor blockers (ARB), and mineralocorticoid receptor antagonists (MRA) decrease mortality and morbidity in heart failure but increase the risk of hyperkalemia, especially when used in combination. Prevention of hyperkalemia and its associated complications requires careful patient selection, counseling regarding dietary potassium intake, awareness of drug interactions, and regular laboratory surveillance. Read More

    A Retrospective Study of Acute Renal Failure in Children: Its Incidence, Etiology, Complications and Prognosis.
    Cureus 2017 May 25;9(5):e1274. Epub 2017 May 25.
    Department of Paediatrics, Nanfang Hospital, Southern Medical University, Guangzhou, P.R.China.
    Background: Acute renal failure (ARF) developed due to various causes and may lead to significant morbidity and mortality among pediatric patients.

    Objectives: The study was conducted to determine the incidence, etiology, outcome of treatment and clinical presentation of ARF in pediatric patients in Somalia.

    Methods: Comprehensive case history of 39 pediatric patients below 12 years of age, admitted with renal diseases in four tertiary care hospitals in Hargeisa and Borama cities in Somalia during December 2015 to November 2016. Read More

    Nutritional status among peritoneal dialysis patients after oral supplement with ONCE dialyze formula.
    Int J Nephrol Renovasc Dis 2017 13;10:145-151. Epub 2017 Jun 13.
    Division of Nephrology, Department of Medicine, Phramongkutklao Hospital and College of Medicine, Bangkok.
    Background: Malnutrition is an important problem in patients treated with long-term dialysis, and most dialysis patients have lower dietary energy and protein intake. This study was undertaken to examine whether orally administered Otsuka Nutrition Pharmaceutical (ONCE) dialyze formula (ODF) supplement would improve energy intake without mineral and electrolyte disturbances in patients with continuous ambulatory peritoneal dialysis (CAPD).

    Methods: The effects of ODF supplementation on nutrition markers including serum albumin and prealbumin concentrations and inflammatory stress in patients with chronic CAPD were evaluated. Read More

    Noninvasive blood potassium measurement using signal-processed, single-lead ecg acquired from a handheld smartphone.
    J Electrocardiol 2017 Jun 8. Epub 2017 Jun 8.
    Department of Internal Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN, USA; Department of Cardiovascular Diseases, Mayo Clinic, 200 First Street SW, Rochester, MN, USA. Electronic address:
    Objective: We have previously used a 12-lead, signal-processed ECG to calculate blood potassium levels. We now assess the feasibility of doing so with a smartphone-enabled single lead, to permit remote monitoring.

    Patients And Methods: Twenty-one hemodialysis patients held a smartphone equipped with inexpensive FDA-approved electrodes for three 2min intervals during hemodialysis. Read More

    Hydrogen gas inhalation inhibits progression to the "irreversible" stage of shock after severe hemorrhage in rats.
    J Trauma Acute Care Surg 2017 Jun 20. Epub 2017 Jun 20.
    1Department of Emergency and Critical Care Medicine, School of Medicine, Keio University, Tokyo, Japan2The Center for Molecular Hydrogen Medicine, Keio Advanced Research Centers3Department of Cardiology, School of Medicine, Keio University, Tokyo, Japan.
    Background: Mortality of hemorrhagic shock primarily depends on whether or not the patients can endure the loss of circulating volume until radical treatment is applied. We investigated whether hydrogen (H2) gas inhalation would influence the tolerance to hemorrhagic shock and improve survival.

    Methods: Hemorrhagic shock was achieved by withdrawing blood until the mean arterial blood pressure reached 30-35 mmHg. Read More

    Nephrology key information for internists.
    J Community Hosp Intern Med Perspect 2017 Mar 6;7(2):70-72. Epub 2017 Jun 6.
    Division of Hospital Medicine, School of Medicine, Jackson, MS, USA.
    Hospitalists and primary care physicians encounter renal disease daily. Although most cases of acute kidney injury (AKI) are secondary to dehydration and resolve by giving fluids, many cases of AKI are due to not uncommon but unfamiliar causes needing nephrology evaluation. Common indications to consult a nephrologist on an emergency basis include hyperkalemia or volume overload in end stage renal disease patients (ESRD). Read More

    Impact of Admission Serum Potassium on Mortality in Patients with Chronic Kidney Disease and Cardiovascular Disease.
    QJM 2017 Jun 16. Epub 2017 Jun 16.
    Division of Nephrology and Hypertension, Department of Medicine, Mayo Clinic, Rochester, MN.
    Background: The aim of this study was to assess the relationship between admission serum potassium (K) and in-hospital mortality in all hospitalized patients stratified by chronic kidney disease (CKD) and/or cardiovascular disease (CVD) status.

    Methods: All adult hospitalized patients who had admission serum K between years 2011 and 2013 were enrolled. Admission serum K was categorized into seven groups (<3. Read More

    Intraoperative Hyperkalemia and Ventricular Arrhythmia During Parathyroidectomy: A Case Report.
    A A Case Rep 2017 Jun 15. Epub 2017 Jun 15.
    From the Department of Anesthesiology, University of North Carolina Hospitals, Chapel Hill, North Carolina.
    We present a case of acute hyperkalemia and ventricular arrhythmia during parathyroidectomy in a patient with end-stage renal disease. This case highlights the under-recognized alterations in potassium homeostasis associated with parathyroidectomy and underscores the importance of preoperative optimization. Read More

    Renoprotective Effect of Angiotensin-Converting Enzyme Inhibitors and Angiotensin II Receptor Blockers in Diabetic Patients with Proteinuria.
    Kidney Blood Press Res 2017 15;42(2):358-368. Epub 2017 Jun 15.
    School of Pharmacy, Taipei, Taiwan.
    Background/aims: Limited evidence exists on the choice of angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs) in diabetic patients with nephropathy. We aim to assess the renal effectiveness and safety of these drugs among diabetic nephropathy patients.

    Methods: This retrospective cohort study was conducted with diabetic nephropathy patients who initiated ACEI or ARB monotherapy. Read More

    Safety of the neprilysin/renin-angiotensin system inhibitor LCZ696.
    Oncotarget 2017 May 31. Epub 2017 May 31.
    Department of Cardiology, Qilu Hospital of Shandong University, Ji'nan, 250012, PR China.
    Objectives: The combined neprilysin/rennin-angiotensin system inhibitor sacubitril/valsartan (LCZ696) has shown its superiority over ACEI/ARB therapy. In view of the existing concern of its adverse effects, we aimed to provide evidence of the safety of the new drug.

    Results: A total of 6 randomized trials with 11,821 subjects were included in this analysis. Read More

    Spironolactone Treatment and Effect on Survival in Chronic Heart Failure Patients with Reduced Renal Function: A Propensity-Matched Study.
    Cardiorenal Med 2017 Feb 20;7(2):128-136. Epub 2017 Jan 20.
    Department of Nephrology, Oslo University Hospital, Ullevål, Oslo, Norway.
    Background/aims: Spironolactone may be hazardous in heart failure (HF) patients with renal dysfunction due to risk of hyperkalemia and worsened renal function. We aimed to evaluate the effect of spironolactone on all-cause mortality in HF outpatients with renal dysfunction in a propensity-score-matched study.

    Methods: A total of 2,077 patients from the Norwegian Heart Failure Registry with renal dysfunction (eGFR <60 mL/min/1. Read More

    Water, electrolyte, acid-base, and trace elements alterations in cirrhotic patients.
    Int Urol Nephrol 2017 Jun 12. Epub 2017 Jun 12.
    Department of Medicine, Geffen School of Medicine, UCLA, Los Angeles, CA, USA.
    Chronic hepatic patients, and particularly those suffering from cirrhosis, are predisposed to different sort of water, electrolyte, acid-base, and trace elements disorders due to their altered liver function, and also to their exposition to infectious, inflammatory, oncologic, and pharmacologic variables whose combination undermines their homeostatic capability. Hyponatremia, hypokalemia, hyperkalemia, hypocalcemia, metabolic acidosis, respiratory, and metabolic alkalosis are the main internal milieu alterations in this group. Read More

    Pseudohypoaldosteronism types I and II: little more than a name in common.
    J Pediatr Endocrinol Metab 2017 May;30(5):597-601
    Nephrology Department, Hospital Sant Joan de Déu (University of Barcelona), Barcelona.
    Pseudohypoaldosteronism (PHA) comprises a diverse group of rare diseases characterized by sodium and potassium imbalances incorrectly attributed to a defect in aldosterone production. Two different forms of PHA have been described, type I (PHAI) and type II (PHAII). PHAI has been subclassified into renal and systemic. Read More

    Treatment-naïve spontaneous tumor lysis syndrome in metastatic prostate adenocarcinoma: An unusual suspect.
    Am J Emerg Med 2017 May 26. Epub 2017 May 26.
    Department of Medicine, SUNY Upstate Medical University, Syracuse, NY, United States. Electronic address:
    Tumor lysis syndrome (TLS) is a potentially fatal condition defined both by laboratory and clinical criteria. It is caused by the catabolism of tumor cells which leads to considerable release and elevated levels of phosphate, potassium and uric acid in the bloodstream. These electrolyte derangements predispose patients to renal tubule uric acid precipitation, acute kidney injury, arrhythmias, neuromuscular irritability and even seizures. Read More

    Evaluation of the Potential for Drug Interactions With Patiromer in Healthy Volunteers.
    J Cardiovasc Pharmacol Ther 2017 Jan 1:1074248417691135. Epub 2017 Jan 1.
    8 Division of Nephrology, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA.
    Introduction: Patiromer is a potassium-binding polymer that is not systemically absorbed; however, it may bind coadministered oral drugs in the gastrointestinal tract, potentially reducing their absorption.

    Methods: Twelve randomized, open-label, 3-period, 3-sequence crossover studies were conducted in healthy volunteers to evaluate the effect of patiromer (perpetrator drug) on absorption and single-dose pharmacokinetics (PK) of drugs (victims) that might be commonly used with patiromer. Subjects received victim drug alone, victim drug administered together with patiromer 25. Read More

    Renin-angiotensin system blockade: Finerenone.
    Nephrol Ther 2017 Apr;13 Suppl 1:S47-S53
    Departamento de Farmacologia, Facultad de Medicina, Universidad Complutense, Instituto de Investigación Sanitaria Gregorio Marañón, Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares, Madrid, Spain.
    Finerenone is a novel selective nonsteroidal mineralocorticoid receptor antagonist. Results in preclinical studies showed that lower doses of finerenone were needed to achieve similar cardiorenal protective effects compared to both spironolactone and eplerenone and phase II studies in finerenone in patients with heart failure, type-2 diabetes mellitus and/or chronic kidney disease are encouraging as the drug is effective and safe in patients on renin-angiotensin system inhibitors (significant reduction in albuminuria and a low rate of hyperkalemia), but the primary end points were "soft" end points (serum potassium, estimated glomerular filtration rate, albuminuria, N-terminal prohormone B-type natriuretic peptide levels). Thus, further, large-scale, long-term phase III trials are needed to confirm whether the greater affinity and selectivity is translated into improved clinical outcomes. Read More

    [Renal replacement therapy for acute kidney injury in the intensive care unit].
    Nephrol Ther 2017 Apr;13 Suppl 1:S13-S21
    Service de réanimation médicochirurgicale, hôpital Louis-Mourier, 178, rue des Renouillers, 92700 Colombes, France; Inserm UMR 1137 infection, antimicrobiens, modélisation, évolution (IAME), 16, rue Henri-Huchard, 75018 Paris, France; UMR 1137 IAME, université Paris-Diderot, Sorbonne Paris Cité, 16, rue Henri-Huchard, 75018 Paris, France.
    Renal replacement therapy for acute kidney injury has been used for more than 60 years. Except when life-threatening metabolic complications such as severe hyperkalaemia are present, renal replacement therapy initiation criteria are the subject of intense debate. Significant progress has been made with the publication of the AKIKI multicenter trial, which showed that a delayed renal replacement therapy initiation strategy (in the absence of life-threatening metabolic complications) was not associated with a difference in mortality compared to an early renal replacement therapy initiation strategy. Read More

    True rate of mineralocorticoid receptor antagonists-related hyperkalemia in placebo-controlled trials: A meta-analysis.
    Am Heart J 2017 Jun 23;188:99-108. Epub 2017 Mar 23.
    Universität des Saarlandes, Klinik für Innere Medizin III, Homburg/Saar, Germany.
    Background: Mineralocorticoid receptor antagonists (MRA) improve survival in heart failure with reduced ejection fraction but are often underused, mostly due to concerns of hyperkalemia. Because hyperkalemia occurs also on placebo, we aimed to determine the truly MRA-related rate of hyperkalemia.

    Methods: We performed a meta-analysis including randomized, placebo-controlled trials reporting hyperkalemia on MRAs in patients after myocardial infarction or with chronic heart failure. Read More

    Mesenchymal stem cells correct haemodynamic dysfunction associated with liver injury after extended resection in a pig model.
    Sci Rep 2017 Jun 1;7(1):2617. Epub 2017 Jun 1.
    Clinics of Visceral, Transplantation, Thoracic and Vascular Surgery, University of Leipzig, Liebigstraße 21, 04103, Leipzig, Germany.
    In patients, acute kidney injury (AKI) is often due to haemodynamic impairment associated with hepatic decompensation following extended liver surgery. Mesenchymal stem cells (MSCs) supported tissue protection in a variety of acute and chronic diseases, and might hence ameliorate AKI induced by extended liver resection. Here, 70% liver resection was performed in male pigs. Read More

    Severe hyperkalemia is rescued by low-potassium diet in renal βENaC-deficient mice.
    Pflugers Arch 2017 May 31. Epub 2017 May 31.
    Department of Pharmacology and Toxicology, University of Lausanne, Rue du Bugnon 27, 1011, Lausanne, Switzerland.
    In adulthood, an induced nephron-specific deficiency of αENaC (Scnn1a) resulted in pseudohypoaldosteronism type 1 (PHA-1) with sodium loss, hyperkalemia, and metabolic acidosis that is rescued through high-sodium/low-potassium (HNa(+)/LK(+)) diet. In the present study, we addressed whether renal βENaC expression is required for sodium and potassium balance or can be compensated by remaining (α and γ) ENaC subunits using adult nephron-specific knockout (Scnn1b(Pax8/LC1)) mice. Upon induction, these mice present a severe PHA-1 phenotype with weight loss, hyperkalemia, and dehydration, but unlike the Scnn1a(Pax8/LC1) mice without persistent salt wasting. Read More

    Differential efficacy profile of aldosterone receptor antagonists, depending on the type of chronic heart failure, whether with reduced or preserved left ventricular ejection fraction-results of a meta-analysis of randomized controlled trials.
    Cardiovasc Diagn Ther 2017 Jun;7(3):272-287
    Geriatric Department, Casa di Cura "S.Maria del Pozzo", Somma Vesuviana (Napoli), Italy.
    Background: Because of renin-angiotensin-aldosterone system (RAAS) activation, the patients with chronic heart failure (CHF) manifest increased ventricular stress, with impaired left ventricular function, and a slowing down in systemic venous drainage. More importantly, a reduction of the patient's life expectancy has been proven in the case of RAAS overstimulation. For these reasons, huge efforts have been made to obtain molecules able to efficaciously antagonize the RAAS overstimulation, such as aldosterone receptor antagonists (ARAs). Read More

    Development of WNK signaling inhibitors as a new class of antihypertensive drugs.
    Bioorg Med Chem 2017 Jul 19;25(14):3845-3852. Epub 2017 May 19.
    Institute of Biomaterials and Bioengineering, Tokyo Medical and Dental University (TMDU), 2-3-10 Kanda-Surugadai, Chiyodaku, Tokyo 101-0062, Japan. Electronic address:
    Pseudohypoaldosteronism type II (PHAII) is characterized by hyperkalemia and hypertension despite a normal glomerular filtration rate. Abnormal activation of the signal cascade of with-no-lysine kinase (WNK) with OSR1 (oxidative stress-responsive kinase 1)/SPAK (STE20/SPS1-related proline/alanine-rich kinase) and NCC (NaCl cotransporter) results in characteristic salt-sensitive hypertension. Thus, inhibitors of the WNK-OSR1/SPAK-NCC cascade are candidates for a new class of antihypertensive drugs. Read More

    A 9-Day-Old With Weight Loss and Diarrhea.
    Pediatrics 2017 May 11;139(5). Epub 2017 Apr 11.
    Cleveland Clinic Children's, Cleveland, Ohio.
    A 9-day-old infant girl presented with diarrhea and weight loss of 19% since birth. She was born via spontaneous vaginal delivery at 39 weeks' gestation to a mother positive for group B Streptococcus who received adequate intrapartum prophylaxis. The infant was formula-fed every 2 to 3 hours with no reported issues with feeding or swallowing. Read More

    An infant presenting with failure to thrive and hyperkalaemia owing to transient pseudohypoaldosteronism: case report.
    Paediatr Int Child Health 2017 May 30:1-4. Epub 2017 May 30.
    a Departments of Paediatrics , Ghent University Hospital , Ghent , Belgium.
    A 3-month-old boy presented with failure to thrive and a history of a prenatally detected unilateral hydroureteronephrosis which was confirmed after birth. His growth and developmental milestones had been normal during the first 2 months but in the third month his appetite was poor with reduced intake but no vomiting. At presentation, his temperature was normal, there was mild dehydration and there was weight loss (his weight had decreased by 270 g in the past month). Read More

    30 YEARS OF THE MINERALOCORTICOID RECEPTOR: Mineralocorticoid receptor null mice: informing cell-type-specific roles.
    J Endocrinol 2017 Jul 26;234(1):T83-T92. Epub 2017 May 26.
    Centre for Endocrinology and MetabolismHudson Institute of Medical Research, Monash Medical Centre, Clayton, Victoria, Australia.
    The mineralocorticoid receptor (MR) mediates the actions of two important adrenal corticosteroid hormones, aldosterone and cortisol. The cell signalling roles of the MR in vivo have expanded enormously since the cloning of human MR gene 30 years ago and the first MR gene knockout in mice nearly 20 years ago. Complete ablation of the MR revealed important roles postnatally for regulation of kidney epithelial functions, with MR-null mice dying 1-2 weeks postnatally from renal salt wasting and hyperkalaemia, with elevated plasma renin and aldosterone. Read More

    Hyperkalemia and cardiac arrest associated with glucose replacement in a patient on spironolactone.
    Am J Emerg Med 2017 May 11. Epub 2017 May 11.
    Mercy Health - Muskegon, Department of Emergency Medicine, Muskegon, MI, United States. Electronic address:
    We present a case of hypoglycemia, which after intravenous glucose replacement, led to cardiac arrest secondary to a profound extracellular potassium shift. The patient was on spironolactone therapy which is known to cause aldosterone resistance (which inhibits the body's ability to prevent potassium shifts) [1]. Physicians typically review medications that cause hypoglycemia, but other medications may interfere with potassium homeostasis with administration of glucose. Read More

    Elevated baseline potassium level within reference range is associated with worse clinical outcomes in hospitalised patients.
    Sci Rep 2017 May 25;7(1):2402. Epub 2017 May 25.
    Department of Internal Medicine, Seoul National University Bundang Hospital, Gyeonggi-do, Korea.
    The clinical significance of elevated baseline serum potassium (K(+)) levels in hospitalised patients is rarely described. Hence, we performed a retrospective study assessing the significance of elevated K(+) levels in a one-year admission cohort. Adult patients without hypokalaemia or end-stage renal disease were included. Read More

    Hyperkalemia in both surgically and medically treated patients with primary aldosteronism.
    J Hum Hypertens 2017 May 25. Epub 2017 May 25.
    Department of Endocrinology, Metabolism and Hypertension, Clinical Research Institute, National Hospital Organization Kyoto Medical Center, Kyoto, Japan.
    Hyperkalemia is an important complication of adrenalectomy for patients with primary aldosteronism (PA). The frequency of hyperkalemia after medication using mineralocorticoid receptor antagonists (MRAs) for PA is unclear. The aim of this study is to investigate the frequency and the risk factors of hyperkalemia after surgery and medication for PA. Read More

    Clinicopathological spectrum of snake bite-induced acute kidney injury from India.
    World J Nephrol 2017 May;6(3):150-161
    Sanjay Vikrant, Ajay Jaryal, Department of Nephrology, Indira Gandhi Medical College, Himachal Pradesh, Shimla 171001, India.
    Aim: To study the clinico-pathological spectrum of snake bite-induced acute kidney injury (AKI).

    Methods: A retrospective study of patients admitted at Indira Gandhi Medical College Hospital, Shimla with snake bite-induced AKI from July 2003 to June 2016. Medical records were evaluated for patient's information on demographic, clinical characteristics, complications and outcome. Read More

    Mathematical Model of Potassium Profiling in Chronic Dialysis.
    Contrib Nephrol 2017 23;190:134-145. Epub 2017 May 23.
    Potassium balance is a difficult task in hemodialysis: low potassium in the dialysate is associated with a high risk of sudden cardiac death, whereas excessive dialysate potassium may provoke insufficient removal and hyperkalemia. A better understanding of the problem can be achieved with the use of mathematical models of solute kinetics. This study is aimed at presenting an improved model of solute kinetics and fluid shifts during hemodialysis. Read More

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