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BMJ Case Rep 2019 Apr 16;12(4). Epub 2019 Apr 16.

Nerancy Neuro-Intensive Care Unit, University of Virginia, Charlottesville, Virginia, USA.

A young man with severe traumatic brain injury and refractory intracranial hypertension was treated with a barbiturate coma. A rare side effect of barbiturates is dyskalaemia. The dyskalaemia presented with acute hypokalaemia that quickly became hyperkalaemia. Read More

Rev Assoc Med Bras (1992) 2019 Mar 11;65(3):469-474. Epub 2019 Apr 11.

Department of Integrated Clinical Discussions, ABC Medical School, Santo André, SP, Brasil.

Introduction: Peripheral neuropathy is a disorder that affects the cell body, axon or myelin of motor or peripheral sensory neurons and occurs in 60-100% of patients who are submitted to dialysis due to chronic kidney disease. Uremic neuropathy (UN) is attributed to the accumulation of organic waste, evident in patients with reduced glomerular filtration rate.

Objectives: This review aims to make clinical characteristics of uremic neuropathy evident enabling early diagnosis and treatment. Read More

J Nephrol 2019 Apr 15. Epub 2019 Apr 15.

Department of Experimental Diagnostic and Specialty Medicine (DIMES), Nephrology, Dialysis and Renal Transplant Unit, S. Orsola Hospital, University of Bologna, Via Massarenti 9, 40100, Bologna, Italy.

Aldosterone is a mineralocorticoid hormone with a well-known effect on the renal tubule leading to water retention and potassium reabsorption. Other major effects of the hormone include the induction of proinflammatory activity that leads to progressive fibrotic damage of the target organs, heart and kidney. Blocking the aldosterone receptor therefore represents an important pharmacological strategy to avoid the clinical conditions deriving from heart failure (CHF) and chronic kidney disease (CKD). Read More

Pediatr Int 2019 Apr 15. Epub 2019 Apr 15.

Department of Allergy, Kanagawa Children's Medical Center, Yokohama, Japan.

Background: Infants with atopic dermatitis who developed hyponatremia and hyperkalemia with raised aldosterone level have been repeatedly described in Japanese domestic literatures. However, similar reports from other countries are scarce.

Methods: Including our experiences, we collected reports of atopic dermatitis complicated with hyponatremia (≤130 mEq/L), written either in English or in Japanese, to delineate the characteristics and to elucidate the pathophysiology of this condition. Read More

SAGE Open Med Case Rep 2019 3;7:2050313X19839529. Epub 2019 Apr 3.

Department of Intensive Care, "Pugliese-Ciaccio" General Hospital, Catanzaro, Italy.

Traumatic rhabdomyolysis is a clinical and biological syndrome secondary to lysis of striated muscle fibers resulting in extended musculoskeletal damage. An acute muscle damage causes the release of constituent elements of the sarcoplasmic reticulum, such as muscle enzymes, potassium, and myoglobin in plasma circulation; these conditions are at great risk of dangerous systemic complications for life such as hypovolemic shock, hyperkalemia, and acute kidney injury. We describe the case of a patient who suffered a severe musculoskeletal and vascular trauma with elevated creatine kinase values and myoglobinemia treated early with coupled plasma filtration adsorption in order to prevent kidney damage, associated with volume replacement, loop diuretics, and correction of metabolic acidosis. Read More

J Emerg Med 2019 Apr;56(4):459-460

Department of Emergency Medicine, The University of Texas Southwestern Medical Center, Dallas, Texas.

J Emerg Med 2019 Apr;56(4):458-459

Second Department of Internal Medicine, Center for Research of Diabetes, Metabolism, and Nutrition, Third Faculty of Medicine, Charles University, University Hospital Kralovske Vinohrady, Prague, Czech Republic.

Ann Hum Genet 2019 Apr 12. Epub 2019 Apr 12.

The Morris Kahn Laboratory of Human Genetics, National Institute for Biotechnology in the Negev and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.

Four affected individuals of consanguineous kindred presented at infancy with an apparently autosomal recessive syndrome of polyuria and hypokalemic metabolic alkalosis, following maternal polyhydramnios and premature delivery, culminating in severe failure to thrive. Hypercalciuria, nephrocalcinosis, and hyperaldosteronism were further apparent as well as an unusual finding of intermittent hypernatremia. Additionally, all patients demonstrated variable micrognathia with upper respiratory airway abnormalities. Read More

Pediatr Transplant 2019 Apr 11:e13411. Epub 2019 Apr 11.

Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK.

Background: In current practice, pediatric kidney transplant recipients receive large volumes of intravenous fluid intraoperatively to establish allograft perfusion, and further fluid to replace urinary and insensible losses postoperatively. Acute electrolyte imbalance can result, with potential for neurological sequelae. We aimed to determine the incidence and severity of postoperative plasma electrolyte imbalance in pediatric kidney transplant recipients managed with the current standard intravenous crystalloid regimen. Read More

Curr Heart Fail Rep 2019 Apr 11. Epub 2019 Apr 11.

Ben Taub General Hospital, Baylor College of Medicine, 1504 Ben Taub Loop, Houston, TX, 77030, USA.

Purpose Of The Review: Hyperkalemia is a common electrolyte abnormality that can lead to life-threatening cardiac arrhythmia. Medical management of acute hyperkalemia revolves around three strategies-stabilizing the myocardium, intracellular shifting of serum potassium, and enhancing elimination of total body potassium via urinary or fecal excretion. In this review, we outline the current evidence behind the acute medical management of hyperkalemia. Read More

Ann Card Anaesth 2019 Apr-Jun;22(2):162-168

Department of Anaesthesiology, SGPGIMS, Lucknow, Uttar Pradesh, India.

Introduction: Potassium is the most abundant cation in intracellular compartment. A deficiency or excess of its serum concentration can be deleterious to the one suffering from a cardiac ailment. Post cardiac surgery patients are often on multiple drugs like angiotensin receptor blockers (ARBs), angiotensin converting enzyme inhibitors (ACEI), diuretics including potassium sparing diuretics which are known to predispose for hyperkalemia. Read More

Eur J Heart Fail 2019 Apr 26;21(4):540. Epub 2018 Nov 26.

J Am Soc Nephrol 2019 Apr 9. Epub 2019 Apr 9.

Institut National de la Santé et de la Recherche Médicale U970, Paris Cardiovascular Research Center, Paris, France;

Background: Mutations in four genes, WNK lysine deficient protein kinase 1 and 4 ( and ), kelch like family member 3 (), or Cullin 3 (), can result in familial hyperkalemic hypertension (FHHt), a rare Mendelian form of human arterial hypertension. Although all mutations result in an increased abundance of WNK1 or WNK4, all FHHt-causing mutations, resulting in the skipping of exon 9, lead to a more severe phenotype.

Methods: We created and compared two mouse models, one expressing the mutant Cul3 protein ubiquitously () and the other specifically in vascular smooth muscle cells (). Read More

Pediatr Nephrol 2019 Apr 8. Epub 2019 Apr 8.

Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, 600 Highland Ave, Madison, WI, 53792, USA.

Background: Hyperkalemia is a potentially life-threatening complication of chronic kidney disease (CKD). Dietary potassium restriction is challenging in infants despite low-potassium formulas. Decreasing potassium in formula using patiromer, a new calcium-based cation exchange polymer may be one option to accomplish this; however, data confirming efficacy is lacking. Read More

J Pediatr Urol 2019 Mar 9. Epub 2019 Mar 9.

Department of Pediatric Urology, CHU Amiens, France.

Background: Secondary pseudohypoaldosteronism (S-PHA) is a life-threatening condition affecting young children with urinary tract malformation (UTM).

Objective: The aim of the study was to highlight the diagnosis of S-PHA in children with UTM and propose appropriate management.

Study Design: The authors retrospectively reviewed cases of S-PHA related to UTM observed at the institution and searched the PubMed® database to review the literature. Read More

Intern Med J 2019 Apr;49(4):546-547

Chungbuk National University Hospital, Cheongju, South Korea.

Swiss Med Wkly 2019 Apr 8;149:w20035. Epub 2019 Apr 8.

Research Centre for Medical Informatics, Directorate of Research and Teaching, University Hospital Zurich and University of Zurich, Switzerland.

Background And Objective: Clinical decision support (CDS) might improve management of potassium-increasing drug-drug interactions (DDI). We studied CDS with five features intended to increase effectiveness: (i) focus on serious DDIs, (ii) fewer notifications, (iii) presentation of current laboratory results, (iv) timing (when adverse event becomes likelier), (v) removal of notification when appropriate.

Methods: We conducted a 1-year, hospital-wide, cluster-randomised controlled trial in the inpatient setting at a large tertiary-care academic medical centre. Read More

BMC Infect Dis 2019 Apr 5;19(1):311. Epub 2019 Apr 5.

Kidney Transplant Program, St. Michael's Hospital, University of Toronto, 61 Queen Street East, 9th Floor, Toronto, ON, M5C 2T2, Canada.

Background: Trimethoprim-sulfamethoxazole (TMP-SMX) is the drug of choice for anti-Pneumocystis jirovecii pneumonia (PcP) prophylaxis in kidney transplant recipients (KTR). Post-transplant management balances preventing PcP with managing TMP-SMX-related adverse effects. TMP-SMX dose reduction addresses adverse effects but its implications to incident PcP are unclear. Read More

Pediatrics 2019 Apr 5. Epub 2019 Apr 5.

Division of Hospital Medicine and

A 21-month-old previously healthy girl presented to the emergency department initially with fever, rhinorrhea, and poor oral intake. She was subsequently discharged from the hospital on amoxicillin for treatment of acute otitis media but presented hours later on the same day with continued poor oral intake, decreased urine output, and lethargy. The patient was afebrile on examination without a focal source of infection or evidence of meningismus, but she was lethargic and minimally responsive to pain and had reduced strength in the upper and lower extremities. Read More

Hypertens Res 2019 Apr 5;42(4):469-482. Epub 2019 Apr 5.

Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University, Fukuoka, Japan.

The efficacy and safety of renin-angiotensin system inhibitors (RAS-I) in hypertensive adults with non-diabetic chronic kidney disease (CKD) differ depending on the presence or the absence of proteinuria. To estimate the effects of RAS-I in this population, we performed a systematic review and meta-analysis of randomized controlled trials where treatment with angiotensin-converting-enzyme inhibitors or angiotensin II receptor blockers were compared with placebo or active controls in adults with non-diabetic CKD. The treatment effects were separately reviewed in patients with and without proteinuria. Read More

South Med J 2019 Apr;112(4):228-233

From the Department of Medicine, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri, Department of Pediatrics, Brookdale Hospital and Medical Center, Brooklyn, New York, and Division of Pediatric Nephrology and Hypertension, Maimonides Medical Center, Brooklyn, New York.

Hyperkalemia is a common problem in both inpatients and outpatients. Many disease states (eg, chronic kidney disease) and medications may precipitate hyperkalemia. There are several drugs now available to treat hyperkalemia. Read More

JAMA Cardiol 2019 Apr 3. Epub 2019 Apr 3.

Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota.

Importance: For patients with chronic kidney disease (CKD), hyperkalemia is common, associated with fatal arrhythmias, and often asymptomatic, while guideline-directed monitoring of serum potassium is underused. A deep-learning model that enables noninvasive hyperkalemia screening from the electrocardiogram (ECG) may improve detection of this life-threatening condition.

Objective: To evaluate the performance of a deep-learning model in detection of hyperkalemia from the ECG in patients with CKD. Read More

Evid Based Complement Alternat Med 2019 3;2019:1925243. Epub 2019 Mar 3.

Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China.

Cardiovascular disease is the major cause of death in dialysis patients. Although aldosterone antagonists were considered a treatment for severe heart failure patients to reduce cardiac mortality, whether treating patients undergoing maintenance dialysis with aldosterone antagonists could reduce the risk of cardiocerebrovascular (CCV) remains unclear. We aim to systematically assess the efficacy and tolerability of the addition of aldosterone antagonists to conventional therapy in patients undergoing maintenance dialysis. Read More

BMJ Open 2019 Apr 1;9(4):e026465. Epub 2019 Apr 1.

Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus N, Denmark.

Objectives: To investigate healthcare costs associated with hyperkalaemia (HK) among patients with chronic kidney disease (CKD), heart failure (HF) or diabetes.

Design: Before-after cohort study of patients with HK and matched patients without HK.

Setting: Population-based databases covering primary and secondary care for the entire of Northern Denmark. Read More

Br J Haematol 2019 Apr 1. Epub 2019 Apr 1.

Section of Clinical Biochemistry, University of Verona, Verona, Italy.

Biomed Res Int 2019 27;2019:6025726. Epub 2019 Feb 27.

Department of Hepatology, Tianjin Third Central Hospital, Tianjin Institute of Hepatobiliary Disease, Tianjin Key Laboratory of Artificial Cell, Tianjin, China.

Background: Hyperkalemia is a serious complication in cirrhotic patients. However, the clinical characteristics, risk factors, and its impact on the outcomes in acute-on-chronic liver failure (ACLF) patients remain unclear.

Methods: We retrospectively recruited 650 ACLF patients in this study. Read More

Exp Ther Med 2019 Apr 21;17(4):3222-3232. Epub 2019 Feb 21.

Department of Anesthesia and Intensive Care, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P.R. China.

Stringent regulations have been established for the intravenous administration of potassium to avoid hyperkalemia in the clinic. The standard approach, however, often does not work well for treating severe hypokalemia. In the present study, a rabbit model of hyperkalemia was used to develop an tailored rapid potassium supplementation strategy and the effectiveness and safety of this new strategy were assessed. Read More

Sr Care Pharm 2019 Apr;34(4):230-242

Five new drugs marketed in 2018 that are used for medical problems often experienced by the elderly have been selected for consideration in this review. The uses and most important properties of these agents are discussed, and a rating for each new drug is determined using the New Drug Comparison Rating system developed by the author (DAH). Advantages, disadvantages, and other important information regarding each new drug are identified and used as the basis for determining the rating. Read More

Postgrad Med 2019 Apr 29;131(3):171-175. Epub 2019 Mar 29.

a Human Physiology Department , Instituto Universitario del Hospital Italiano de Buenos Aires , Buenos Aires , Argentina.

Hyperchloremic metabolic acidosis of renal origin results from a defect in renal tubular acidification mechanism, and this tubular dysfunction can consist of an altered tubular proton secretion or bicarbonate reabsorption capability. Studies have documented that all forms of renal tubular acidosis (RTA), type I to IV, are documented in kidney transplant patients. Among RTA pathophysiologic mechanisms have been described the renal mass reduction, hyperkalemia, hyperparathyroidism, graft rejection, immunologic diseases, and some drugs such as renin-angiotensin-aldosterone blockers, and calcineurin inhibitors. Read More

Diabetes Obes Metab 2019 Mar 29. Epub 2019 Mar 29.

Division of Diabetes, Endocrinology and Gastroenterology, Faculty of Medicine, Biology and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK.

Hyperglycaemia is common in hospitalized individuals, and is often caused by physiological stress associated with critical illness or major surgery. Insulin therapy is an established treatment for hyperglycaemia and acute hyperkalaemia, and has also been used for myocardial dysfunction resistant to inotropic support. Insulin is commonly used in both organ donors and transplant recipients for hyperglycaemia, but the underlying knowledge base supporting its use remains limited. Read More

J Am Heart Assoc 2019 Apr;8(7):e011814

3 Division of Pulmonary and Critical Care Medicine Department of Internal Medicine Mayo Clinic Rochester MN.

Background Hyperkalemia has been associated with increased mortality in patients with myocardial infarction, but few data exist regarding hyperkalemia in cardiac intensive care unit ( CICU ) patients. We hypothesize that hyperkalemia is associated with increased mortality in unselected CICU patients. Methods and Results We retrospectively reviewed a historical cohort of 9681 CICU patients admitted from January 2007 to December 2015. Read More

Medicine (Baltimore) 2019 Mar;98(13):e14967

Department of Cardiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.

Background: Recent studies have shown the efficacy for using spironolactone to treat heart failure with reduced ejection fraction (HFrEF), but the efficacy of spironolactone for heart failure with mid-range ejection fraction (HFmrEF) and heart failure with preserved ejection fraction (HFpEF) is unclear. This meta-analysis investigated the efficacy and safety of spironolactone in patients with HFmrEF and HFpEF.

Methods And Results: We searched several databases including PubMed and the Cochrane Collaboration, for randomized controlled trials (RCTs) that assessed spironolactone treatment in HFmrEF and HFpEF. Read More

Curr Rheumatol Rev 2019 Mar 28. Epub 2019 Mar 28.

Department of Pharmaceutical Sciences in Persian Medicine, School of Persian and Complementary Medicine, Mashhad University of Medical Sciences, Mashhad. Iran.

Background: Osteoarthritis (OA) is a type of progressive rheumatoid disease, which leads to the degeneration of the articular cartilage, synovium, subchondral bone, tendons, and the surrounding ligaments.There are various treatments for knee OA, including pharmaceutical, non-pharmaceutical, and surgical treatments. Considering the chronic nature of the disease as well as the necessity for the long-term use of chemical medications, various side effects could occur that include gastrointestinal bleeding, hypertension, congestive heart failure, hyperkalemia, and kidney failure. Read More

JAMA 2019 Mar;321(12):1200-1210

Department of Intensive Care, Aarhus University Hospital, Aarhus, Denmark.

Importance: In-hospital cardiac arrest is common and associated with a high mortality rate. Despite this, in-hospital cardiac arrest has received little attention compared with other high-risk cardiovascular conditions, such as stroke, myocardial infarction, and out-of-hospital cardiac arrest.

Observations: In-hospital cardiac arrest occurs in over 290 000 adults each year in the United States. Read More

Pol Merkur Lekarski 2019 Mar;46(273):115-121

Medical University of Warsaw: Department of Pediatrics and Nephrology.

Acute poststreptococcal glomerulonephritis (APSGN) is a complication of infection with group A beta-hemolytic streptococcus. The disease manifests as microscopic/gross hematuria, arterial hypertension, edema, and acute kidney injury and has most commonly self-limiting course.

Aim: The aim of study was the analysis of clinical course of APSGN in period of increased incidence in the first half of 2018. Read More

BMC Nephrol 2019 Mar 25;20(1):104. Epub 2019 Mar 25.

Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University, Seoul, 03722, Republic of Korea.

Background: Guidelines for general hypertension treatment do not recommend the combined use of renin-angiotensin-aldosterone system (RAAS) inhibitors due to the risk of hyperkalemia. However, a recent clinical trial showed that polycystic kidney disease (PKD) patients had infrequent episodes of hyperkalemia despite receiving combined RAAS inhibitors. Because intrarenal RAAS is a main component for renal potassium handling, we further investigated the association between intrarenal RAAS activity and serum potassium level in patients with chronic kidney disease, particularly in PKD patients, and examined whether intrarenal RAAS activity has a prognostic role in patients with PKD. Read More

BMJ Case Rep 2019 Mar 22;12(3). Epub 2019 Mar 22.

Sanz Medical Centre, Laniado Hospital, Netanya, Israel.

An elderly patient who presented with recent recurrent falls was admitted, reporting inability to stand and recent acute diarrhoeal illness. Paraparesis was diagnosed but extensive investigations did not elucidate its cause. He had atherosclerotic cardiac and vascular disease, diabetes, hypertension, chronic kidney disease and pancreatectomy/splenectomy for a lesion that turned out to be benign. Read More

Kidney Int 2019 Apr;95(4):747-749

Université de Lorraine, CIC 1433, U 1116, Inserm, CHRU de Nancy, and FCRIN INI-CRCT (Cardiovascular and Renal Clinical Trialists), Nancy, France.

The Spin-D (Safety and Cardiovascular Efficacy of Spironolactone in Dialysis-Dependent End-Stage Renal Disease) and MiREnDa (Mineralocorticoid Receptor Antagonists in End-Stage Renal Disease) trials taken together provide the reassuring demonstration that up to 25 mg/d spironolactone is reasonably safe, provided maintenance hemodialysis patients are properly monitored and investigators use a per-protocol therapeutic algorithm to manage hyperkalemia. These results should encourage and reassure the investigators of the 2 currently ongoing, large, international, major-outcome clinical trials, both of which are using spironolactone up to 25 mg/d: ACHIEVE (Aldosterone bloCkade for Health Improvement EValuation in End-stage Renal Disease trial; NCT03020303) and ALCHEMIST (ALdosterone antagonist Chronic HEModialysis Interventional Survival Trial; NCT01848639). Read More

Nefrologia 2019 Mar 18. Epub 2019 Mar 18.

Servicio de Nefrología, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, España.

Background: Hyperkalaemia is a significant electrolyte imbalance in chronic kidney disease (CKD). Renin-angiotensin-aldosterone system inhibitors (RAASi) have beneficial cardio-renal properties, although they can often cause hyperkalaemia.

Objective: To examine the prevalence of hyperkalaemia in CKD, identify factors associated with its appearance and the relationship between hyperkalaemia and mortality. Read More

Ther Hypothermia Temp Manag 2019 Mar 20. Epub 2019 Mar 20.

1 Department of Anesthesiology and Intensive Care Medicine and University Hospital of Cologne, Cologne, Germany.

To date, the optimal cooling device for targeted temperature management (TTM) remains unclear. Water-circulating cooling blankets are broadly available and quickly applied but reveal inaccuracy during maintenance and rewarming period. Recently, esophageal heat exchangers (EHEs) have been shown to be easily inserted, revealed effective cooling rates (0. Read More

Rev Assoc Med Bras (1992) 2019 Feb;65(2):281-286

Department of Integrated Clinical Discussions, ABC Medical School, Av. Príncipe de Gales, 821, CEP 09060-650, Santo André, SP, Brasil.

Introduction: Peripheral neuropathy is a disorder that affects the cell body, axon or myelin of motor or peripheral sensory neurons and occurs in 60-100% of patients who are submitted to dialysis due to chronic kidney disease. Uremic neuropathy is attributed to the accumulation of organic waste, evident in patients with reduced glomerular filtration rate.

Objectives: This review aims to make clinical characteristics of uremic neuropathy evident enabling early diagnosis and treatment. Read More

Drugs 2019 Apr;79(5):591

Springer, Private Bag 65901, Mairangi Bay, Auckland, 0754, New Zealand.

The article Sodium Zirconium Cyclosilicate: A Review in Hyperkalaemia, written by Sheridan M. Hoy, was originally published Online First without open access. Read More

Core Evid 2019 27;14. Epub 2019 Feb 27.

[This corrects the article on p. 11 in vol. 12, PMID: 28356904. Read More

Hematology 2019 Dec;24(1):355-361

a Department of Hematology and Hematopoietic Stem Cell Transplantation , Yamanashi Prefectural Central Hospital , Kofu , Japan.

Objectives: To explore real-world prognoses for tyrosine kinase inhibitor (TKI) discontinuation in chronic myeloid leukemia (CML) patients and the associated reasons for TKI discontinuation.

Methods: We investigated, using the medical records of 85 consecutive CML patients who received TKIs between December 2001 and August 2016 at our hospital, reasons for discontinuation, duration of TKI treatment before discontinuation, molecular response (MR) status at TKI discontinuation, treatment-free remission (TFR) duration, and overall survival after TKI discontinuation.

Results: TKI therapy was discontinued in 21 patients. Read More

J Insect Physiol 2019 Apr 14;114:116-124. Epub 2019 Mar 14.

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

Cold exposure is known to induce stressful imbalances in chill susceptible insects, including loss of hemolymph water, hyperkalemia and cell depolarization. Cold induced depolarization induces uncontrolled Ca influx and accumulation of injury through necrosis/apoptosis. Conversely cold induced Ca influx has been shown to induce rapid cold hardening and therefore also play a role to reduce cold injury. Read More

Rev Port Cardiol 2019 Feb 15;38(2):105-111. Epub 2019 Mar 15.

Serviço de Cardiologia, Centro Hospitalar de Setúbal, Setúbal, Portugal.

Introduction: In iatrogenic or potentially reversible bradyarrhythmia, drug discontinuation or metabolic correction is recommended before permanent cardiac pacemaker (PM) implantation. These patients often have conduction system disease and there are few data on recurrence or the need for a permanent PM.

Objective: To analyze the need for PM implantation in patients with iatrogenic bradyarrhythmia or bradyarrhythmia associated with other potentially reversible causes. Read More

Cardiovasc Diabetol 2019 03 16;18(1):33. Epub 2019 Mar 16.

Institut für Epidemiologie und medizinische Biometrie, ZIBMT; Universität Ulm, Ulm, Germany.

Background: To evaluate the characteristics of type 2 diabetes (T2DM) patients with or without chronic kidney disease (CKD) in Germany.

Methods: Using combined DPV/DIVE registry data, the analysis included patients with T2DM at least ≥ 18 years old who had an estimated glomerular filtration rate (eGFR) value available. CKD was defined as an eGFR < 60 mL/min/1. Read More

Curr Opin Nephrol Hypertens 2019 May;28(3):238-244

Department of Community Health Sciences, Max Rady College of Medicine, University of Manitoba.

Purpose Of Review: Although renin-angiotensin aldosterone system (RAAS) inhibitors have become the mainstay treatment for patients with chronic diseases, hyperkalemia is a major contributory deterrent to their use in patients with chronic kidney disease (CKD) and heart failure. For the first time in 50 years, two new therapies (patiromer and ZS-9) have recently emerged for the concomitant treatment of hyperkalemia in these patients. The objective of this review is to discuss the efficacy and safety of these new agents. Read More