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    Hyperkalemia is Associated with Increased 30-Day Mortality in Hip Fracture Patients.
    Calcif Tissue Int 2017 Feb 17. Epub 2017 Feb 17.
    Department of Clinical Biochemistry, Bispebjerg Hospital, University of Copenhagen, Bispebjerg Bakke 23, 2400, Copenhagen NV, Denmark.
    Abnormal plasma concentrations of potassium in the form of hyper- and hypokalemia are frequent among hospitalized patients and have been linked to poor outcomes. In this study, we examined the prevalence of hypo- and hyperkalemia in patients admitted with a fractured hip as well as the association with 30-day mortality in these patients. A total of 7293 hip fracture patients (aged 60 years or above) with admission plasma potassium measurements were included. Read More

    Application of a pattern of incremental haemodialysis, based on residual renal function, when starting renal replacement therapy.
    Nefrologia 2017 Jan - Feb;37(1):39-46
    Sección de Nefrología, Hospital Universitario del Henares, Coslada (Madrid), España.
    Introduction: The interest in the preservation of residual kidney function on starting renal replacement therapy (RRT) is very common in techniques such as peritoneal dialysis but less so in haemodialysis (HD). In our centre the pattern of incremental dialysis (2 HD/week) has been an option for a group of patients. Here we share our experience with this regimen from March 2008. Read More

    Advances in the management of hyperkalemia in chronic kidney disease.
    Curr Opin Nephrol Hypertens 2017 Feb 15. Epub 2017 Feb 15.
    aDepartment of Medicine, Schulich School of Medicine and Dentistry bInstitute of Clinical Evaluative Sciences cFaculty of Epidemiology and Biostatistics, Western University, London, Ontario, Canada.
    Purpose Of Review: Patients with chronic kidney disease (CKD) have an increased risk of hyperkalemia that increases both short-term and long-term mortality. Historically, managing hyperkalemia has relied upon dietary modifications, augmentation of urinary potassium excretion and enhanced enteral potassium elimination. This review discusses current treatments and their limitations and summarizes the evidence supporting novel agents for potassium lowering in patients with CKD. Read More

    Hypermagnesemia disturbances in rats, NO-related: pentadecapeptide BPC 157 abrogates, L-NAME and L-arginine worsen.
    Inflammopharmacology 2017 Feb 16. Epub 2017 Feb 16.
    Department of Pharmacology, School of Medicine, University of Zagreb, Salata 11, P.O. Box 916, 10000, Zagreb, Croatia.
    Aim: Stable gastric pentadecapeptide BPC 157, administered before a high-dose magnesium injection in rats, might be a useful peptide therapy against magnesium toxicity and the magnesium-induced effect on cell depolarization. Moreover, this might be an NO-system-related effect. Previously, BPC 157 counteracts paralysis, arrhythmias and hyperkalaemia, extreme muscle weakness; parasympathetic and neuromuscular blockade; injured muscle healing and interacts with the NOS-blocker and NOS-substrate effects. Read More

    Prevention and treatment of tumor lysis syndrome, and the efficacy and role of rasburicase.
    Onco Targets Ther 2017 2;10:597-605. Epub 2017 Feb 2.
    Department of Internal Medicine I, University Hospital Carl Gustav Carus at the Technische Universitaet Dresden, Dresden.
    Tumor lysis syndrome (TLS) is a potentially life-threatening condition that occurs in oncologic and hematologic patients with large tumor burden, either due to cytotoxic therapy or, less commonly, spontaneously because of massive tumor cell lysis. TLS is clinically characterized by acute renal failure, hyperuricemia, hyperkalemia, hyperphosphatemia, and hypocalcemia. While limited options are available for treating TLS, identifying patients at high risk for developing TLS and prevention in high-risk patients remain an important aspect in the treatment of cancer patients. Read More

    Clinical profile of kidney involvement preceding diagnosis of multiple myeloma; a single center experience.
    J Nephropharmacol 2016 29;5(2):98-101. Epub 2015 Mar 29.
    Department of Nephrology and Clinical Transplantation, Institute of Kidney Diseases and Research Center, Dr. HL Trivedi Institute of Transplantation Sciences (IKDRC-ITS), Ahmedabad, India.
    Introduction: The kidneys are involved in significant number of patients with multiple myeloma (MM) who can present with acute or chronic renal failure, nephritic syndrome, non-nephrotic proteinuria or tubular function defects. Objectives: To assess the clinical profile of kidney involvement preceding diagnosis of multiple myeloma Patients and Methods: Renal involvement in 29 cases with MM admitted over an 18-month period to our tertiary care center was retrospectively examined. Diagnosis of MM was confirmed by two or more of the following four features: lytic bone lesions, serum or urine monoclonal peak, Bence-Jones proteinuria, and greater than 20% plasma cells in bone marrow. Read More

    The Effect of Co-Trimoxazole on Serum Potassium Concentration: Safety Evaluation of a Randomised Controlled Trial.
    Br J Clin Pharmacol 2017 Feb 13. Epub 2017 Feb 13.
    Norwich Medical School, University of East Anglia, Norwich, UK.
    Aims: Co-trimoxazole maintains a well-established role in the treatment of Pneumocystis jirovecii and Toxoplasma gondii, as well as urinary tract infections. Observational studies report hyperkalemia associated with co-trimoxazole which may stem from an amiloride-like potassium sparing effect. Our study reports on changes in serum potassium on patients without acute infections, and the influence of concomitant anti-kaliuretic drugs on this effect. Read More

    Corrected to uncorrected? The metabolic conundrum of hypertrophic pyloric stenosis.
    J Pediatr Surg 2017 Jan 28. Epub 2017 Jan 28.
    Division of Pediatric General Surgery, IWK Health Centre; Dalhousie University; Halifax, Nova Scotia, Canada.
    Objectives: The purpose of this study was to evaluate factors associated with repeat blood testing after establishment of normal metabolic parameters and factors associated with reversal of metabolic correction back an uncorrected form in preoperative management of infants with Hypertrophic Pyloric Stenosis (HSP).

    Methods: A retrospective review of infants with HSP undergoing repeat serum chemistries after already having normal labs were identified. Variables associated with repeating normal bloodwork and reversion of normal to abnormal labs were identified. Read More

    The renal TRPV4 channel is essential for adaptation to increased dietary potassium.
    Kidney Int 2017 Feb 7. Epub 2017 Feb 7.
    Department of Integrative Biology and Pharmacology, the University of Texas Health Science Center at Houston, Houston, Texas, USA. Electronic address:
    To maintain potassium homeostasis, kidneys exert flow-dependent potassium secretion to facilitate kaliuresis in response to elevated dietary potassium intake. This process involves stimulation of calcium-activated large conductance maxi-K (BK) channels in the distal nephron, namely the connecting tubule and the collecting duct. Recent evidence suggests that the TRPV4 channel is a critical determinant of flow-dependent intracellular calcium elevations in these segments of the renal tubule. Read More

    Correction Equation for Estimation of Actual Potassium Concentration in Hemolyzed Specimen.
    Clin Lab 2017 Feb;63(2):271-275
    Background: A spuriously elevated serum potassium value could possibly cause medical decision errors because it leads to masked hypokalemia or pseudohyperkalemia. The aim of this study was to develop a correction equation for falsely elevated potassium level caused by hemolysis.

    Methods: A total of 988 samples with a hemolysis index (HI) value greater than the potassium alert HI value were recollected within two hours from initial collection. Read More

    [Severe hyperkalemia in patients referred to an emergency departement: the role of antialdosterone drugs and of renin-angiotensin system blockers].
    G Ital Nefrol 2017 Jan-Feb;34(1)
    We analyzed the clinical features and the factors associated with the presence of hyperkalemia (serum potassium >5.3 mmol/L) in a cohort of patients presenting to an Emergency Department. A total of 168 cases were observed (89 males and 79 females), mean age 77. Read More

    Unexpected Complication of Cocaine-Associated Anti-Neutrophil Cytoplasmic Antibody Vasculitis Related to Persistent In-Hospital Cocaine Use.
    J Addict Med 2017 Feb 3. Epub 2017 Feb 3.
    Department of Emergency Medicine, Hennepin County Medical Center, Minneapolis, MN.
    Introduction: Levamisole-adulterated cocaine has been implicated in anti-neutrophil cytoplasmic antibody (ANCA) vasculitis. We present a case of spontaneous intraperitoneal hemorrhage, an unexpectedly severe complication of cocaine-related ANCA vasculitis, developing late during hospitalization.

    Case Report: An adult male with a history of hepatitis C, distant cocaine use, and limited health care presented to a local emergency department (ED) with volume overload, renal failure, hyperkalemia and non-anion gap metabolic acidosis. Read More

    Mineralocorticoid antagonists in ESRD: an overview of their efficacy and safety.
    Curr Vasc Pharmacol 2017 Feb 1. Epub 2017 Feb 1.
    Division of Nephrology and Hypertension, 1st Department of Medicine, AHEPA Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
    Add-on mineralocorticoid-receptor-antagonists (MRAs) spironolactone and eplerenone can enhance the cardioprotective action of angiotensin-converting-enzyme-inhibitors (ACEIs), angiotensin-receptor-blockers (ARBs) and/or β-blockers in non-dialysis patients with congestive heart failure (CHF) and reduced left ventricular (LV) ejection fraction. The efficacy and safety of MRAs among patients on chronic dialysis is less well studied. A growing body of evidence derived from small randomized studies suggests that MRA therapy may improve a number of surrogate cardiovascular (CV) risk factors (i. Read More

    Complications in mechanically ventilated patients of Guillain-Barre syndrome and their prognostic value.
    J Neurosci Rural Pract 2017 Jan-Mar;8(1):68-73
    Department of Biostatistics, NIMHANS, Bengaluru, Karnataka, India.
    Introduction: The spectrum of various complications in critically ill Guillain-Barre syndrome (GBS) and its effect on the prognosis is lacking in literature. This study aimed at enumerating the complications in such a cohort and their significance in the prognosis and mortality.

    Materials And Methods: Retrospective case record analysis of all consecutive mechanically ventilated patients of GBS in neurology Intensive Care Unit (ICU) of a tertiary care institute for 10 years was done. Read More

    Metabolic toxicities in patients undergoing treatment for nonhematological malignancy: A cross-sectional study.
    Indian J Med Paediatr Oncol 2016 Oct-Dec;37(4):256-259
    Department of Radiation Oncology, Dr. B. R. Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India.
    Objectives: The objective of this study was to evaluate the prevalence of metabolic toxicities in patients with different nonhematological malignancies admitted in oncology ward of a tertiary cancer care center while on treatment.

    Methods: We did this cross-sectional study over a period of 7 months (January-July 2013) for all adult patients (n = 280) who, while undergoing anti-cancer therapy at our center, got admitted to our oncology inpatient ward with metabolic toxicity. Grading of toxicity was done using National Cancer Institute Common Terminology Criteria for Adverse Events Version 4. Read More

    The Relation of Serum Potassium Concentration with Cardiovascular Events and Mortality in Community-Living Individuals.
    Clin J Am Soc Nephrol 2017 Feb 31;12(2):245-252. Epub 2017 Jan 31.
    Due to the number of contributing authors, the affiliations are provided in the Supplemental Material.
    Background And Objectives: Hyperkalemia is associated with adverse outcomes in patients with CKD and in hospitalized patients with acute medical conditions. Little is known regarding hyperkalemia, cardiovascular disease (CVD), and mortality in community-living populations. In a pooled analysis of two large observational cohorts, we investigated associations between serum potassium concentrations and CVD events and mortality, and whether potassium-altering medications and eGFR<60 ml/min per 1. Read More

    [Takotsubo cardiomyopathy recurrence in patient with chronic kidney disease: case report and literature review].
    G Ital Nefrol 2016 Nov-Dec;33(6)
    Takotsubo cardiomyopathy (CT) is a syndrome characterized by an acute and transient left ventricular dysfunction, electrocardiographic abnormalities suggestive of acute coronary syndrome, chest pain and/or dyspnea, left ventricular mid-apical segments akinesia and normal coronary angiography. It is mainly observed in postmenopausal women after an intense physical or mental stress. The course is usually favourable but sometimes severe complications occur. Read More

    Effectiveness of patiromer in the treatment of hyperkalemia in chronic kidney disease patients with hypertension on diuretics.
    J Hypertens 2017 Feb 15. Epub 2017 Feb 15.
    aDivision of Nephrology, Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland bRelypsa, Inc., Redwood City, California cDivision of Nephrology, Department of Medicine, University of Rochester School of Medicine, Rochester, New York dDivision of Nephrology and Hypertension, University of Miami Miller School of Medicine, Miami, Florida, USA.
    Objective: Recurrent hyperkalemia frequently limits use of renin-angiotensin-aldosterone system inhibitors (RAASi) in chronic kidney disease (CKD) patients with hypertension, diabetes, and/or heart failure. Patiromer is a sodium-free, nonabsorbed potassium (K)-binding polymer approved by the US Food and Drug Administration for the treatment of hyperkalemia. This post-hoc analysis of OPAL-HK examined the effectiveness and safety of patiromer in reducing serum K in hyperkalemic CKD patients on RAASi, with hypertension, receiving diuretic therapy versus those not on diuretics. Read More

    Hyperkalemia masked by pseudo-stemi infarct pattern and cardiac arrest.
    Int J Emerg Med 2017 Dec 26;10(1). Epub 2017 Jan 26.
    Department of Internal Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston, 6431 Fannin, MSB 1.150, Houston, 77030, TX, USA.
    Background: Hyperkalemia is a common electrolyte abnormality and has well-recognized early electrocardiographic manifestations including PR prolongation and symmetric T wave peaking. With severe increase in serum potassium, dysrhythmias and atrioventricular and bundle branch blocks can be seen on electrocardiogram. Although cardiac arrest is a worrisome consequence of untreated hyperkalemia, rarely does hyperkalemia electrocardiographically manifest as acute ischemia. Read More

    Consequences of Androctonus mauretanicus and Buthus occitanus scorpion venoms on electrolyte levels in rabbits.
    Heliyon 2017 Jan 5;3(1):e00221. Epub 2017 Jan 5.
    Laboratory of Venoms and Toxins, Pasteur Institute of Morocco, 1 Place Louis Pasteur, Casablanca, 20360, Morocco.
    Androctonus mauretanicus (A. mauretanicus) and Buthus occitanus (B. occitanus) scorpions, which belong to the Buthidae family, are the most venomous scorpions in Morocco. Read More

    Systematic Review and Meta-Analysis of Patiromer and Sodium Zirconium Cyclosilicate: A New Armamentarium for the Treatment of Hyperkalemia.
    Pharmacotherapy 2017 Jan 25. Epub 2017 Jan 25.
    Department of Biostatistics, School of Public Health and Health Professions, University at Buffalo.
    Objective: To compare and contrast the efficacy and safety of patiromer and sodium zirconium cyclosilicate (ZS-9) in the treatment of hyperkalemia.

    Design: A systematic review and meta-analysis of phase II and III clinical trial data was completed.

    Patients Or Participants: Eight studies (2 phase II and 4 phase III trials with 2 subgroup analyses) were included in the qualitative analysis whereas six studies (2 phase II and 4 phase III trials) were included in the meta-analysis. Read More

    The Impact of Renin-Angiotensin System Blockade on Renal Outcomes and Mortality in Pre-Dialysis Patients with Advanced Chronic Kidney Disease.
    PLoS One 2017 25;12(1):e0170874. Epub 2017 Jan 25.
    Division of Nephrology, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea.
    Renin-angiotensin-system (RAS) blockade is thought to slow renal progression in patients with chronic kidney disease (CKD). However, it remains uncertain if the habitual use of RAS inhibitors affects renal progression and outcomes in pre-dialysis patients with advanced CKD. In this multicenter retrospective cohort study, we identified 2,076 pre-dialysis patients with advanced CKD (stage 4 or 5) from a total of 33,722 CKD patients. Read More

    Emergency Department Use among Patients with CKD: A Population-Based Analysis.
    Clin J Am Soc Nephrol 2017 Feb 24;12(2):304-314. Epub 2017 Jan 24.
    Departments of Community Health Sciences and.
    Background And Objectives: Although prior studies have observed high resource use among patients with CKD, there is limited exploration of emergency department use in this population and the proportion of encounters related to CKD care specifically.

    Design, Setting, Participants, & Measurements: We identified all adults (≥18 years old) with eGFR<60 ml/min per 1.73 m(2) (including dialysis-dependent patients) in Alberta, Canada between April 1, 2010 and March 31, 2011. Read More

    Serum Potassium and Short-term Clinical Outcomes Among Hemodialysis Patients: Impact of the Long Interdialytic Interval.
    Am J Kidney Dis 2017 Jan 19. Epub 2017 Jan 19.
    Relypsa Inc, Redwood City, CA.
    Background: Hyperkalemia is common among hemodialysis patients and is associated with morbidity and mortality. The long interdialytic interval is likewise associated with adverse outcomes. However, the interplay among serum potassium, dialysis cycle phase, and clinical outcomes has not been examined. Read More

    A propensity score-matched analysis of the impact of minimum inhibitory concentration on mortality in patients with Pseudomonas aeruginosa bacteraemia treated with piperacillin/tazobactam.
    Int J Antimicrob Agents 2017 Jan 17. Epub 2017 Jan 17.
    Critical Care, Oklahoma City VA Medical Center, Oklahoma City, OK, USA.
    The Clinical and Laboratory Standards Institute (CLSI) recently re-examined Pseudomonas aeruginosa minimum inhibitory concentration (MIC) susceptibility breakpoints for piperacillin/tazobactam (TZP). The objectives of this study were to analyse the impact of elevated TZP MICs (32-64 mg/L) versus lower respective MICs on P. aeruginosa bacteraemia patient outcomes. Read More

    Effects of mineralocorticoid receptor antagonists on the progression of diabetic nephropathy.
    J Diabetes Investig 2017 Jan 20. Epub 2017 Jan 20.
    Department of Nephrology, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, 200092, China.
    Aims: We aimed to evaluate the potential benefits and adverse effects of adding a mineralocorticoid receptor antagonist (MRA) to angiotensin converting enzyme inhibitors (ACEI) and/or angiotensin receptor blockers (ARB), as standard treatment in patients with DN.

    Materials And Methods: We scanned the Embase, PubMed, and Cochrane Central Register of Controlled Trials databases for human clinical trials published in English until June 2016, evaluating renal outcomes in patients with DN.

    Results: A total of 18 randomized controlled trials involving 1,786 patients were included. Read More

    Severe hyperkalemia following blood transfusions: Is there a link?
    World J Nephrol 2017 Jan;6(1):53-56
    Christos V Rizos, Haralampos J Milionis, Moses S Elisaf, Department of Internal Medicine, Medical School, University of Ioannina, 45110 Ioannina, Greece.
    Patients with gastrointestinal bleeding often require large volume blood transfusion. Among the various side effects of blood transfusion, the increase of potassium levels is a serious one which is often overlooked. We report a case of severe hyperkalemia in a patient with gastric bleeding after large volume transfusion of packed red blood cells. Read More

    Glucocorticoid-induced leucine zipper protein regulates sodium and potassium balance in the distal nephron.
    Kidney Int 2017 Jan 13. Epub 2017 Jan 13.
    Division of Nephrology, Department of Medicine, University of California, San Francisco, California, USA. Electronic address:
    Glucocorticoid induced leucine zipper protein (GILZ) is an aldosterone-regulated protein that controls sodium transport in cultured kidney epithelial cells. Mice lacking GILZ have been reported previously to have electrolyte abnormalities. However, the mechanistic basis has not been explored. Read More

    Effect of valsartan on kidney outcomes in people with impaired glucose tolerance.
    Diabetes Obes Metab 2017 Jan 17. Epub 2017 Jan 17.
    BHF Glasgow Cardiovascular Research Centre, University of Glasgow, UK.
    Aims: Renin-angiotensin system blockers reduce the incidence and progression of microalbuminuria and the subsequent development of end-stage renal disease (ESRD) in patients with type 2 diabetes. We aimed to examine the effect of valsartan on kidney outcomes in patients with impaired glucose tolerance (IGT).

    Methods: In a double-blind randomized trial, 9306 patients with IGT were assigned to valsartan (160 mg daily) or placebo. Read More

    Use of ace-inhibition and blood pressure management in deferring dialysis initiation.
    Panminerva Med 2017 Jan 13. Epub 2017 Jan 13.
    Department of Nephrology and Dialysis, A. Manzoni Hospital, ASST Lecco, Lecco, Italy -
    Elevated blood pressure is one of the most significant risk factor for the development of chronic kidney disease (CKD); its treatment is a milestone in CKD management. While it is accepted that a stricter blood pressure control is indicated in patients with proteinuria or microalbuminuria, the exact degree of blood pressure reduction to be obtained in CKD patients is still under debate. Following more recent interpretation of old trials, a BP target for < 140/90 mmHg is suggested for non-proteinuric CKD patients. Read More

    The Impact Exerted on Clinical Outcomes of Patients With Chronic Heart Failure by Aldosterone Receptor Antagonists: A Meta-Analysis of Randomized Controlled Trials.
    J Clin Med Res 2017 Feb 31;9(2):130-142. Epub 2016 Dec 31.
    Division of Cardiology, Istituto Nazionale per lo Studio e la Cura dei Tumori, "Fondazione Giovanni Pascale" IRCCS, Napoli, Italy.
    Background: Aldosterone receptor antagonists (ARAs) have been associated with improved clinical outcomes in patients with heart failure with reduced left ventricular ejection fraction (HFREF), but not in those with heart failure with preserved left ventricular ejection fraction (HFpEF). With the aim to study this topic more deeply, we carried out a meta-analysis of selective and non-selective ARAs in HFREF and HFpEF.

    Methods: We searched PubMed and Scopus databases. Read More

    Parasite-induced increases in the energy costs of movement of host freshwater fish.
    Physiol Behav 2017 Mar 10;171:127-134. Epub 2017 Jan 10.
    Research Institute of Fish Culture and Hydrobiology, South Bohemian Research Center of Aquaculture and Biodiversity of Hydrocenoses, Faculty of Fisheries and Protection of Waters, University of South Bohemia in České Budějovice, Zátiší 728/II, 389 25 Vodňany, Czech Republic.
    Parasitization by the larvae (glochidia) of freshwater mussels can cause harm to a fish's gills, resulting in less effective respiration and/or reduced activity by the host fish. The impact of glochidia infections on the host's physiology remains poorly understood, and no information is available concerning energy consumption in parasitized fish. Hence, we obtained glochidia of the invasive unionid mussel Sinanodonta (Anodonta) woodiana and experimentally infected common carp, Cyprinus carpio, tagged with physiological sensors to measure energy consumption. Read More

    Brugada sign in a patient with hyperkalemia due to rhabdomyolysis in hypothermia.
    J Electrocardiol 2016 Dec 29. Epub 2016 Dec 29.
    St. John of God Hospital Cardiology Department, Budapest, Hungary.
    The Brugada sign may appear as an indication of severe hyperkalemia. This phenomena has recently been called as the "Brugada phenocopy". Hyperthermia and hypothermia may lead to rhabdomyolysis. Read More

    Multi-organ dysfunction due to bath salts: are we aware of this entity?
    Intern Med J 2017 Jan;47(1):109-111
    Department of Critical Care Medicine, Royal Hobart Hospital, Hobart, Tasmania, Australia.
    Methylenedioxypyrovalerone (MDPV) is a synthetic, cathinone-derivative, central nervous system stimulant taken to produce a cocaine- or methamphetamine-like high. Physical manifestations include tachycardia, hypertension, arrhythmias, hyperthermia, sweating, rhabdomyolysis, hyperkalaemia, disseminated intravascular coagulation, oliguria and seizures. We report a patient who presented with severe metabolic acidosis, multi-organ dysfunction, rhabdomyolysis, hyperkalaemia and seizures. Read More

    Characterization of Mineralocorticoid Receptor Antagonist Therapy Initiation in High-Risk Patients With Heart Failure.
    Circ Cardiovasc Qual Outcomes 2017 Jan;10(1)
    From the Inova Heart and Vascular Institute, Falls Church, VA (L.B.C.); Department of Medicine (L.B.C., E.D.P., M.L.M., L.H.C., A.F.H.) and Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC (B.G.H., E.D.P., L.H.C., A.F.H.); Department of Internal Medicine, University of Michigan School of Medicine, Ann Arbor (B.P.); and Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, NC (M.L.M.).
    Background: Heart failure guidelines recommend routine monitoring of serum potassium, and renal function in patients treated with a mineralocorticoid receptor antagonist (MRA). How these recommendations are implemented in high-risk patients or according to setting of drug initiation is poorly characterized.

    Methods And Results: We conducted a retrospective cohort study of Medicare beneficiaries linked to laboratory data in 10 states with prevalent heart failure as of July 1, 2011, and incident MRA use between May 1 and September 30, 2011. Read More

    In Silico Investigation into Cellular Mechanisms of Cardiac Alternans in Myocardial Ischemia.
    Comput Math Methods Med 2016 13;2016:4310634. Epub 2016 Dec 13.
    Department of Mechanical, Aerospace, and Biomedical Engineering, University of Tennessee, Knoxville, TN 37996, USA.
    Myocardial ischemia is associated with pathophysiological conditions such as hyperkalemia, acidosis, and hypoxia. These physiological disorders may lead to changes on the functions of ionic channels, which in turn form the basis for cardiac alternans. In this paper, we investigated the roles of hyperkalemia and calcium handling components played in the genesis of alternans in ischemia at the cellular level by using computational simulations. Read More

    The effectiveness of apneic oxygenation during tracheal intubation in various clinical settings: a narrative review.
    Can J Anaesth 2017 Jan 3. Epub 2017 Jan 3.
    Department of Anesthesia, Toronto Western Hospital, University Health Network, University of Toronto, MC2-405, 399 Bathurst Street, Toronto, ON, M5T 2S8, Canada.
    Purpose: During the process of tracheal intubation, patients are apneic or hypoventilating and are at risk of becoming hypoxemic. This risk is especially high in patients with acute or chronic respiratory failure and accompanying compromised respiratory reserve. To address this concern, apneic oxygenation can be administered during tracheal intubation to aid in maintaining arterial oxygen saturation. Read More

    A Comparative Effectiveness Study of Renal Parameters Between Imidapril and Amlodipine in Patients with Hypertension: A Retrospective Cohort Study.
    Cardiol Ther 2017 Jan 2. Epub 2017 Jan 2.
    Division of Pharmacology, Department of Biomedical Sciences, Nihon University School of Medicine, 30-1 Oyaguchi-Kamimachi, Itabashi-ku, Tokyo, 173-8610, Japan.
    Introduction: Imidapril is an angiotensin converting enzyme inhibitor (ACEI) that is frequently used as an antihypertensive drug in Japan. Although ACEIs are known to have adverse effects of decreasing glomerular filtration rate (GFR) and causing hyperkalemia, there are very few clinical data on the long-term effect of imidapril on glomerular function. We conducted a retrospective cohort study using a clinical database to evaluate and compare the long-term effects of imidapril and amlodipine on renal parameters in Japanese hypertensive patients in routine clinical practice. Read More

    [Hyperkalemia - current therapuetic strategies].
    Wiad Lek 2016;69(5):745-748
    Katedra i Klinika Nefrologii, Dializoterapii i Chorób Wewnętrznych WUM, Warszawa, Polska.
    Hyperkalemia is a medical emergency that requires immediate therapy, followed by interventions aimed at preventing its recurrence. Hyperkalemia occurs especially frequently in patients with chronic kidney disease (CKD), in part because of impaired kidney function and in part due to coexisting comorbidities such as diabetes or heart failure and the medications used to treat them, first of all the inhibitors of renin-angiotensin-aldosterone system (RAASi). Both acute and chronic management of hyperkalemia are equally important, though, with currently available therapeutic possibilities, the effective restoration of potassium homeostasis are in fact limited to the correction of its triggers. Read More

    Hypokalemia during acute metabolic acidosis on hemodilution with succinylated gelatin in rats.
    J Surg Res 2016 Oct 4;209:45-52. Epub 2016 Oct 4.
    University Hospital Essen, Institute of Physiological Chemistry, University of Duisburg-Essen, Essen, North Rhine-Westphalia, Germany.
    Background: Extracellular metabolic acidosis of mineral origin is commonly associated with plasma hyperkalemia. Nevertheless, in previous experiments, animals subjected to acute metabolic acidosis induced by normovolemic hemodilution using a colloidal volume replacement solution containing succinylated gelatin (gelafundin), developed a hypokalemic state with concomitant marked increases in diuresis and renal potassium excretion. In the present study, the succinylated gelatin's impact on diuresis and consequently potassium excretion was studied. Read More

    Low pHo boosts burst firing and catecholamine release by blocking TASK-1 and BK channels while preserving Cav1 channels in mouse chromaffin cells.
    J Physiol 2016 Dec 27. Epub 2016 Dec 27.
    Department of Drug Science, Laboratory of Cellular and Molecular Neuroscience, N.I.S. Centre, CNISM Unit, 10125 Torino, Italy.
    Mouse chromaffin cells (MCCs) generate action potential (AP) firing that regulates the Ca(2+) -dependent release of catecholamines (CAs). Recent findings indicate that MCCs possess a variety of spontaneous firing modes that span from the common "tonic-irregular" to the less frequent "burst" firing. This latter is evident in a small fraction of MCCs but occurs regularly when Nav1. Read More

    A randomized controlled study of finerenone versus placebo in Japanese patients with type 2 diabetes mellitus and diabetic nephropathy.
    J Diabetes Complications 2016 Dec 14. Epub 2016 Dec 14.
    AMC Nishi Umeda Clinic, Osaka, Japan.
    Aims: Finerenone (BAY 94-8862) is a novel non-steroidal mineralocorticoid receptor antagonist. The aim of this study was to compare the efficacy and safety of seven once-daily oral doses of finerenone (1.25-20mg) and placebo in 96 patients with type 2 diabetes mellitus (T2DM) and diabetic nephropathy (DN) receiving a RAS blocker. Read More

    DELAYED DIAGNOSIS OF A 17-HYDROXYLASE/17,20-LYASE DEFICIENT CASE PRESENTED WITH 46,XY FEMALE: LOW NORMAL POTASSIUM CAN ALERT CLINICIAN.
    J Clin Res Pediatr Endocrinol 2016 Dec 23. Epub 2016 Dec 23.
    17-hydroxylase/17,20-lyase deficiency (17OHD) is a rare autosomal recessive defect in adrenal and gonadal steroidogenesis, causes absence of secondary sexual characteristics frequently associated with hypertension and hyperkalemia. Here we report a 46, XY case, who had normal potassium levels and without hypertension. Here we present a 2,5 years old female admitted with female external genitalia and inguinal swelling. Read More

    Sacubitril/Valsartan (LCZ696) in Heart Failure.
    Handb Exp Pharmacol 2016 Dec 22. Epub 2016 Dec 22.
    Novartis Pharmaceuticals Corporation, One Health Plaza, East Hanover, NJ, 07936-1080, USA.
    It has been known since the 1990s that long-term morbidity and mortality is improved in patients with heart failure with reduced ejection fraction (HFrEF) by treatments that target the renin-angiotensin-aldosterone system (RAAS). It has also long been thought that enhancement of the activity of natriuretic peptides (NPs) could potentially benefit patients with HFrEF, but multiple attempts to realize this benefit had failed over the years - until 2014, when a large, phase III, randomized, controlled clinical trial (PARADIGM-HF) was completed comparing sacubitril/valsartan with enalapril, a well-established treatment for HFrEF. Sacubitril/valsartan (formerly known as LCZ696) is a first-in-class angiotensin receptor neprilysin inhibitor (ARNI) that simultaneously suppresses RAAS activation through blockade of angiotensin II type 1 receptors and enhances vasoactive peptides including NPs through inhibition of neprilysin, the enzyme responsible for their degradation. Read More

    Superior Mesenteric Artery Syndrome with Abdominal Compartment Syndrome.
    Case Rep Emerg Med 2016 27;2016:7809281. Epub 2016 Nov 27.
    University of Texas Dell Medical School, Emergency Medicine Residency, Austin, TX, USA.
    Superior Mesenteric Artery (SMA) syndrome is a condition in which the duodenum becomes compressed between the SMA and the aorta, resulting in bowel obstruction which subsequently compresses surrounding structures. Pressure on the inferior vena cava (IVC) and aorta decreases cardiac output which compromises distal blood flow, resulting in abdominal compartment syndrome with ischemia and renal failure. A 15-year-old male with SMA syndrome presented with 12 hours of pain, a distended, rigid abdomen, mottled skin below the waist, and decreased motor and sensory function in the lower extremities. Read More

    Effect of telmisartan on kidney function in patients with chronic kidney disease: an observational study.
    J Drug Assess 2016 4;5(1):24-28. Epub 2016 Nov 4.
    Department of Pharmacy, Bharat Institute of Technology , Ranga Reddy , Telangana , India.
    Background: Globally the burden of chronic kidney disease (CKD) is rising, an important cause of death and loss of disability-adjusted life years. Activation of the renin-angiotensin-aldosterone system is involved in its pathogenesis. The aim of the present study was to examine the effects of telmisartan (40 mg/day), an angiotensin receptor blocker (ARB) in Indian patients with CKD in real-life setting. Read More

    Tumor lysis syndrome in solid tumors: Clinical characteristics and prognosis.
    Med Clin (Barc) 2017 Feb 16;148(3):121-124. Epub 2016 Dec 16.
    Servicio de Oncología Médica, Hospital Universitario Ramón y Cajal, Madrid, España.
    Introduction And Objective: Tumour lysis syndrome (TLS) is an uncommon complication in solid tumors following treatment initiation, and its spontaneous development (STLS) is exceptional. In this study, we analyse the main clinical and prognostic features of a case series with TLS and STLS.

    Material And Methods: Observational retrospective study in which we included all patients with solid tumours diagnosed with TLS and STLS over a period of 16 years, according to Cairo-Bishop criteria. Read More

    Hydrofluoric acid burns in the western Zhejiang Province of China: a 10-year epidemiological study.
    J Occup Med Toxicol 2016 7;11:55. Epub 2016 Dec 7.
    Department of Burns & Wound Care Center, Second Affiliated Hospital of Zhejiang University College of Medicine, Hangzhou, 310009 China.
    Background: Chemical burns caused by hydrofluoric acid (HF) frequently occur in the Western Zhejiang Province. This study aimed to investigate the epidemiological characteristics of HF burns within this region.

    Methods: A 10-year retrospective analysis was conducted using data from all inpatients with HF burns. Read More

    Chorein Sensitive Orai1 Expression and Store Operated Ca2+ Entry in Rhabdomyosarcoma Cells.
    Cell Physiol Biochem 2016 14;40(5):1141-1152. Epub 2016 Dec 14.
    Department of Cardiology, Vascular Medicine and Physiology, University of Tuebingen, Germany.
    Background: Chorein, a protein encoded by VPS13A (vacuolar protein sorting-associated protein 13A), is defective in chorea acanthocytosis, a rare disease characterized by acanthocytosis of red blood cells and neuronal cell death with progressive hyperkinetic movement disorder, cognitive dysfunction, behavioral abnormalities and chronic hyperkalemia. Chorein is highly expressed in ZF rhabdomyosarcoma cells and counteracts apoptosis of those cells. Chorein is effective in part by interacting with and fostering stimulation of phosphoinositide-3-kinase (PI3K)-p85-subunit. Read More

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