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    1 OF 172

    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

    Racial and Ethnic Differences in Mortality Associated with Serum Potassium in a Large Hemodialysis Cohort.
    Am J Nephrol 2017 May 20;45(6):509-521. Epub 2017 May 20.
    Harold Simmons Center for Kidney Disease Research and Epidemiology, University of California Irvine, School of Medicine, Orange, CA, USA.
    Background: Hyperkalemia is observed in chronic kidney disease patients and may be a risk factor for life-threatening arrhythmias and death. Race/ethnicity may be important modifiers of the potassium-mortality relationship in maintenance hemodialysis (MHD) patients given that potassium intake and excretion vary among minorities.

    Methods: We examined racial/ethnic differences in baseline serum potassium levels and all-cause and cardiovascular mortality using Cox proportional hazard models and restricted cubic splines in a cohort of 102,241 incident MHD patients. Read More

    Effects of calcineurin inhibitors on sodium excretion in recipients of allogeneic hematopoietic stem cell transplantation.
    Int J Hematol 2017 May 17. Epub 2017 May 17.
    Division of Hematology, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
    Calcineurin inhibitors (CIs) such as cyclosporine A (CSA) and tacrolimus often cause renal dysfunction, resulting in increased serum creatinine, hyperkalemia, and hyperuricemia. However, the effects of CIs on sodium excretion have not been fully elucidated. We retrospectively evaluated the effects of CI administration on sodium excretion in recipients of allogeneic hematopoietic stem cell transplantation (HSCT). Read More

    Transient Left Bundle Branch Block due to Severe Hyperkalemia.
    Cardiol Res 2017 Apr 3;8(2):77-80. Epub 2017 May 3.
    Department of Medicine, Bronx Lebanon Hospital Center, Bronx, NY 10457, USA.
    Hyperkalemia is a potentially life-threatening electrolyte imbalance that can lead to sudden death from cardiac arrhythmias and asystole. We present a case of transient left bundle branch block pattern on an electrocardiogram (ECG) secondary to hyperkalemia in a patient with history of end-stage renal disease. A 52-year-old man presented to the emergency room (ER) with chief complaints of weakness and lethargy after missing his regularly scheduled session of hemodialysis. Read More

    Familial Hyperkalemia and Hypertension (FHHt) and KLHL3: Description of a Family with a New Recessive Mutation (S553L) Compared to a Family with a Dominant Mutation, Q309R, with Analysis of Urinary Sodium Chloride Cotransporter.
    Nephron 2017 May 17. Epub 2017 May 17.
    Department of Nephrology and Hypertension, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
    Background: Familial hyperkalemia and hypertension (FHHt) is an inherited disorder manifested by hyperkalemia and hypertension. The following four causative genes were identified: WNK1, WNK4, CUL3, and KLHL3. For the first 3 genes, inheritance is autosomal dominant. Read More

    Comparative effectiveness of angiotensin-converting enzyme inhibitors versus angiotensin II receptor blockers for major renal outcomes in patients with diabetes: A 15-year cohort study.
    PLoS One 2017 15;12(5):e0177654. Epub 2017 May 15.
    Department of Internal Medicine, National Taiwan University Hospital and College of Medicine, Taipei City, Taiwan.
    Background: Angiotensin converting enzyme inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs) are considered to have similar renoprotective effects; so far there has been no consensus about their priorities. This study aimed to compare ACEIs and ARBs for major renal outcomes and survival in a 15-year cohort of adults with diabetes.

    Methods: This study utilized Taiwan's medical and pharmacy claims data in the Longitudinal Cohort of Diabetes Patients. Read More

    Lp25 membrane protein from pathogenic Leptospira spp. is associated with rhabdomyolysis and oliguric acute kidney injury in a guinea pig model of leptospirosis.
    PLoS Negl Trop Dis 2017 May 15;11(5):e0005615. Epub 2017 May 15.
    Laboratory of Medical Investigation (LIM12), Clinical Hospital, Nephrology Department, São Paulo, Brazil.
    Acute kidney injury (AKI) from leptospirosis is frequently nonoliguric with hypo- or normokalemia. Higher serum potassium levels are observed in non-survivor patients and may have been caused by more severe AKI, metabolic disarrangement, or rhabdomyolysis. An association between the creatine phosphokinase (CPK) level and maximum serum creatinine level has been observed in these patients, which suggests that rhabdomyolysis contributes to severe AKI and hyperkalemia. Read More

    Experience using high-dose glucose-insulin-potassium (GIK) in critically ill patients.
    J Crit Care 2017 Apr 26;41:72-77. Epub 2017 Apr 26.
    Department of Critical Care, University College London Hospitals NHS Foundation Trust, London NW1 2BU, United Kingdom; Bloomsbury Institute of Intensive Care Medicine, Division of Medicine, University College London, Gower Street, London WC1E 6BT, United Kingdom.
    Purpose: To audit the use of GIK in terms of safety, haemodynamic effects, and impact on catecholamine dosage.

    Materials And Methods: A retrospective, descriptive, evaluative audit of GIK use within the adult ICU of a London teaching hospital was conducted. Rescue therapy of GIK (up to 1. Read More

    Evaluation of water and electrolytes disorders in severe acute diarrhea patients treated by WHO protocol in eight large hospitals in Tehran; a nephrology viewpoint.
    J Renal Inj Prev 2017 24;6(2):109-112. Epub 2016 Nov 24.
    Department of Internal Medicine, Semnan University of Medical Sciences, Semnan, Iran.
    Introduction: The most common cause of death from diarrhea is the shock caused by dehydration, electrolytes and acid-base disorders. Objectives: The aim of this study was to evaluate water and electrolytes disorders in diarrhea patients after treating severe acute diarrhea. Patients and Methods: In this study we used a historical cohort and studied patients who were hospitalized due to acute diarrhea and were similarly treated for dehydration and water and electrolyte disorders as recommended by the World Health Organization (WHO) guideline. Read More

    A curious case of persistently relapsing hyperkalemia in an ESRD patient on maintenance hemodialysis following bioprosthetic aortic valve replacement - a potential case for the use of the new agent, patiromer, for hyperkalemia management.
    J Renal Inj Prev 2017 24;6(1):30-34. Epub 2016 Sep 24.
    Department of Medicine, Nnamdi Azikiwe Teaching Hospital, PMB 5025, Nnewi, Anambra State, Nigeria.
    Hyperkalemia is not uncommon in patients with end-stage renal disease (ESRD) on maintenance hemodialysis, often related to dietary indiscretion, following the prolonged inter-dialytic weekend interval in patients on thrice weekly hemodialysis treatments, and sometimes the adverse effects of medications such as RAAS blocking agents. Moreover, hyperkalemia following extended cardiac surgery can result from the use of high-potassium containing cardioplegic solutions used during cardiopulmonary bypass. Nevertheless, different from the foregoing, in the nephrology literature, there have been very rare reports of potentially life-threatening hyperkalemia following cardiac valve replacement procedure. Read More

    Implementation of a timed, electronic, assessment-driven potassium-replacement protocol.
    Am J Health Syst Pharm 2017 May 9. Epub 2017 May 9.
    Boulder Community Health, Boulder, CO.
    Purpose: The adherence to and effectiveness and safety of a timed, electronic, assessment-driven potassium-replacement protocol (TARP) were compared with an electronic nurse-driven replacement protocol (NRP) are reported.

    Methods: A retrospective observational study was conducted in a community hospital evaluating protocol adherence, effectiveness, and safety for 2 potassium-replacement protocols. All adults on medical units with an order for potassium replacement per protocol during the 3-month trial periods were reviewed. Read More

    Severe hyperkalaemia complicating parathyroidectomy in patients with end-stage renal disease.
    Anaesth Intensive Care 2017 May;45(3):365-368
    Consultant, Department of Renal Medicine, The Alfred Hospital and Baker IDI Heart and Diabetes Institute, Melbourne, Victoria.
    We evaluated the incidence of perioperative hyperkalaemia in end-stage renal disease (ESRD) patients undergoing parathyroidectomy and investigated possible contributors to this phenomenon. This was a retrospective cohort study looking at patients who had undergone parathyroidectomy for chronic kidney disease-associated mineral bone disease (CKD-MBD) at The Alfred Hospital, Melbourne, since 2001. Baseline demographics including age, gender, aetiology of renal failure and mode of renal replacement therapy as well as anaesthetic technique and duration of surgery were studied as possible contributors. Read More

    Expert Panel Recommendations for the Identification and Management of Hyperkalemia and Role of Patiromer in Patients with Chronic Kidney Disease and Heart Failure.
    J Manag Care Spec Pharm 2017 Apr;23(4-a Suppl):S10-S19
    1 Baylor College of Medicine, Texas Medical Center, Houston.
    Virtual panel meetings were conducted among 7 physicians, all of whom are independent experts, including 3 nephrologists, 2 cardiologists, and 2 emergency medicine physicians (the panel). The panel met with the purpose of discussing the current treatment landscape, treatment challenges, economic impact, and gaps in care for patients with hyperkalemia that is associated with heart failure and chronic kidney disease. The stated goal of the panel discussion was to develop practical solutions in the identification and management of hyperkalemia in this patient population. Read More

    Clinical and Economic Impact of Hyperkalemia in Patients with Chronic Kidney Disease and Heart Failure.
    J Manag Care Spec Pharm 2017 Apr;23(4-a Suppl):S2-S9
    2 Relypsa, Redwood City, California.
    Background: Hyperkalemia (HK) is a concern for patients with chronic kidney disease (CKD) and heart failure (HF), and for those receiving treatments that inhibit the renin-angiotensin-aldosterone system (RAASi). An analysis of 1.7 million medical records of patients in the United States revealed that among individuals with more than 2 potassium values during 2007 to 2012, HK was detected in 34. Read More

    Systemic Pseudohypoaldosteronism Type I: A Case Report and Review of the Literature.
    Case Rep Pediatr 2017 18;2017:7939854. Epub 2017 Apr 18.
    Division of Pediatric Endocrinology, Rhode Island Hospital and The Warren Alpert Medical School of Brown University, Providence, RI, USA.
    Systemic pseudohypoaldosteronism (PHA) type I is a rare genetic disorder resulting from mutations in the subunits of the epithelial sodium channel that manifests as severe salt wasting, hyperkalemia, and metabolic acidosis in infancy. In this article we report a patient with systemic PHA type I presenting with severe dehydration due to salt wasting at 6 days of life. She was found to have a known mutation in the SCNN1A gene and subsequently required treatment with sodium supplementation. Read More

    Tumor Lysis Syndrome: A Unique Solute Disturbance.
    Nurs Clin North Am 2017 Jun 7;52(2):309-320. Epub 2017 Apr 7.
    Department of Acute and Continuing Care, University of Texas Health Science Center at Houston, 6901 Bertner Avenue SON 654, Houston, TX 77030, USA.
    Tumor lysis syndrome (TLS) is a life-threatening disorder that is an oncologic emergency. Risk factors for TLS are well-known, but the current literature shows case descriptions of unexpected acute TLS. Solid tumors and untreated hematologic tumors can lyse under various circumstances in children and adults. Read More

    Spironolactone for the Treatment of Acne: A 4-Year Retrospective Study.
    Dermatology 2017 May 5. Epub 2017 May 5.
    Department of Dermatology, University of Cincinnati, Cincinnati, OH, USA.
    Prior studies have demonstrated that spironolactone is an effective second-line treatment option for postadolescent acne, but has notable side effects. Data are, however, limited. We therefore present a 4-year retrospective study evaluating 291. Read More

    The dilemma of dual renin-angiotensin system blockade in chronic kidney disease: why beneficial in animal experiments but not in the clinic?
    Physiol Res 2017 May;66(2):181-192
    Department of Nephrology, First Faculty of Medicine, Charles University, Prague, Czech Republic, Center for Experimental Medicine, Institute for Clinical and Experimental Medicine, Prague, Czech Republic.
    Drugs interfering with the renin-angiotensin-aldosterone system (RAAS) improved the prognosis in patients with hypertension, heart failure, diabetes and chronic kidney disease. However, combining different drugs brought no further benefit while increasing the risk of hyperkalemia, hypotension and acute renal failure. This was so with combining angiotensin converting enzyme inhibitors (ACEi) and angiotensin II receptors type 1 antagonists (ARB). Read More

    Fatal cardiac glycoside poisoning due to mistaking foxglove for comfrey.
    Clin Toxicol (Phila) 2017 May 2:1-4. Epub 2017 May 2.
    b Department of Emergency Medicine , Chang Gung Memorial Hospital, Linkou Branch , Taoyuan , Taiwan.
    Context: Accidental ingestion of foxglove (Digitalis purpurea) can cause significant cardiac toxicity. We report a patient who ingested foxglove mistaking it for comfrey and developed refractory ventricular arrhythmias. The patient died despite treatment with digoxin-specific antibody fragments (DSFab) and veno-arterial extracorporeal membrane oxygenation (VA-ECMO). Read More

    Hyperkalaemia prevalence, recurrence and management in chronic haemodialysis: a prospective multicentre French regional registry 2-year survey.
    Nephrol Dial Transplant 2017 Apr 28. Epub 2017 Apr 28.
    Association Lorraine de Traitement de l'Insuffisance Rénale, Nancy, France.
    Background.: Observational studies have reported increased mortality rates in hyperkalaemic or hypokalaemic chronic haemodialysis patients. This study assessed the prevalence and recurrence of hyperkalaemia (HK) along with the concomitant prescription of low-potassium (K) dialysis baths and of K-binding agents in a registry within a French regional disease management programme. Read More

    An Exceptional Case of Diabetic Ketoacidosis.
    Case Rep Emerg Med 2017 26;2017:4351620. Epub 2017 Mar 26.
    Emergency Department, AZ Nikolaas, Sint-Niklaas, Belgium.
    We present a case of diabetic ketoacidosis, known as one of the most serious metabolic complications of diabetes. We were confronted with rapid neurological deterioration and unseen glycaemic values, which reached almost 110 mmol/L, subsequently resulting in hyperkalaemia and life-threatening dysrhythmias. This is the first reported live case with such high values of blood glucose and a favourable outcome. Read More

    Outcomes analysis of surgical and medical treatments for patients with primary aldosteronism.
    Endocr J 2017 Apr 29. Epub 2017 Apr 29.
    Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea.
    Patients with aldosterone-producing adenomas are treated using surgery, and patients with idiopathic hyperaldosteronism receive medical treatment using mineralocorticoid receptor antagonists (MRAs). However, the outcomes of surgical and medical treatment for primary aldosteronism (PA) remain unclear. Therefore, we compared the outcomes of surgical and medical treatment for PA and aimed to identify a specific subgroup that might benefit from medical treatment. Read More

    Short-term changes of serum potassium concentration induced by physical exercise in patient with arterial hypertension treated with angiotensin-converting enzyme inhibitor alone or in combination with statin.
    J Physiol Pharmacol 2017 Feb;68(1):133-138
    Medical University of Lodz, Department of Nephrology, Hypertension and Kidney Transplantation, Lodz, Poland.
    Intensive physical exercise may facilitate potassium release from skeletal muscles that may result in hyperkalemia. Commonly used drugs including angiotensin converting enzyme inhibitors (ACEI) and statins increase a risk of hyperkalemia. It is not known whether the effect of these drugs on serum potassium during physical exercise is additive. Read More

    Mineralocorticoid Receptor Blockade in End-Stage Renal Disease.
    Curr Hypertens Rep 2017 May;19(5):40
    Nephrology Section, Stratton VA Medical Center, 113 Holland Ave, Albany, NY, 12208, USA.
    Purpose Of Review: The purpose of this study was to summarize recent findings about cardiovascular benefits and safety of aldosterone blockade in patients with end-stage renal disease (ESRD).

    Recent Findings: It is now well recognized that aldosterone's deleterious cardiovascular impact is not limited to its pressor effect arising from an increase in sodium reabsorption in the kidneys. Aldosterone has also been shown to increase blood pressure by a direct activation of the sympathetic nervous system, to cause endothelial and vascular smooth muscle cell dysfunction, myocardial remodeling and fibrosis, and to have pro-arrhythmogenic actions in the heart. Read More

    Dual RAAS Blockade with Aliskiren in Patients with Severely Impaired Chronic Kidney Disease.
    Exp Clin Endocrinol Diabetes 2017 Apr 27. Epub 2017 Apr 27.
    Center for Geriatric Medicine at Bezirksklinikum Regensburg, Regensburg, Germany.
    Dual renin-angiotensin-aldosterone blockade (dRAASb) is purposed in the prevention of the cardiorenal syndrome (CRS). However, all attempts with dRAASb even in patients with moderate impaired chronic kidney disease (CKD) were terminated due to the typical severe adverse events (SAE), e. g. Read More

    Hyperkalemia After Laparoscopic Nephrectomy in Patients With Renal Insufficiency: A Case Report.
    A A Case Rep 2017 Apr 26. Epub 2017 Apr 26.
    From the *Division of Pediatric Urology, Children's Hospital at Dartmouth, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire; †Banner Children's Specialists, Pediatric Urology, Cardon Children's Medical Center, Mesa, Arizona; and ‡Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts.
    Laparoscopic surgery is an evolving surgical modality in children, which has been applied to increasingly more complex surgeries and patients, including patients with renal insufficiency. These patients are particularly susceptible to the challenges that laparoscopy imposes on their altered physiology, leading to marked electrolyte disturbances, including metabolic acidosis and hyperkalemia. Hyperkalemia has the potential for marked impairment of cardiac conduction. Read More

    Anesthetic consideration for neuromuscular diseases.
    Curr Opin Anaesthesiol 2017 Jun;30(3):435-440
    Northshore University Health System, University of Chicago, Pritzker School of Medicine, Illinois, USA.
    Purpose Of Review: The aim of this review is to examine data relating to perioperative management of the patient with neuromuscular disorders RECENT FINDINGS: Patients with pre-existing neuromuscular disorders are at risk for a number of postoperative complications that are related to anesthetic drugs that are administered intraoperatively. Careful preoperative assessment is necessary to reduce morbidity and mortality. In particular, the risk of postoperative respiratory failure and need for long-term ventilation should be reviewed with patients. Read More

    Constitutively Active SPAK Causes Hyperkalemia by Activating NCC and Remodeling Distal Tubules.
    J Am Soc Nephrol 2017 Apr 25. Epub 2017 Apr 25.
    Department of Physiology, Maryland Kidney Discovery Center, University of Maryland Medical School, Baltimore, Maryland; and
    Aberrant activation of with no lysine (WNK) kinases causes familial hyperkalemic hypertension (FHHt). Thiazide diuretics treat the disease, fostering the view that hyperactivation of the thiazide-sensitive sodium-chloride cotransporter (NCC) in the distal convoluted tubule (DCT) is solely responsible. However, aberrant signaling in the aldosterone-sensitive distal nephron (ASDN) and inhibition of the potassium-excretory renal outer medullary potassium (ROMK) channel have also been implicated. Read More

    Clinical and Economic Impact of Hyperkalemia in Patients with Chronic Kidney Disease and Heart Failure.
    J Manag Care Spec Pharm 2017 Apr;23(4-a Suppl):S2-S9
    2 Relypsa, Redwood City, California.
    Background: Hyperkalemia (HK) is a concern for patients with chronic kidney disease (CKD) and heart failure (HF), and for those receiving treatments that inhibit the renin-angiotensin-aldosterone system (RAASi). An analysis of 1.7 million medical records of patients in the United States revealed that among individuals with more than 2 potassium values during 2007 to 2012, HK was detected in 34. Read More

    Phosphate imbalance in patients with heart failure.
    Heart Fail Rev 2017 May;22(3):349-356
    Department of Internal Medicine, School of Medicine, University of Ioannina, 451 10, Ioannina, Greece.
    Patients with heart failure often exhibit electrolyte abnormalities, such as hyponatremia or hypokalemia/hyperkalemia. Although not as common as the other electrolyte disturbances observed in patients with heart failure, phosphate imbalance is also of high importance in this population. The aim of this review is to present the mechanisms of low or high phosphate serum levels in patients with heart failure and its role in the pathogenesis and progression of heart dysfunction. Read More

    The Right Ventricle Is Dilated During Resuscitation From Cardiac Arrest Caused by Hypovolemia: A Porcine Ultrasound Study.
    Crit Care Med 2017 Apr 20. Epub 2017 Apr 20.
    1Research Center for Emergency Medicine, Aarhus University Hospital, Denmark. 2Department of Anesthesiology, Randers Regional Hospital, Denmark. 3Department of Anesthesiology and Intensive Care Medicine, Aarhus University Hospital, Denmark. 4Research & Development, Prehospital Emergency Medical Services, Central Denmark Region, Denmark. 5Department of Internal Medicine, Randers Regional Hospital, Denmark.
    Objectives: Dilation of the right ventricle during cardiac arrest and resuscitation may be inherent to cardiac arrest rather than being associated with certain causes of arrest such as pulmonary embolism. This study aimed to compare right ventricle diameter during resuscitation from cardiac arrest caused by hypovolemia, hyperkalemia, or primary arrhythmia (i.e. Read More

    Effect of transfusion of washed red blood cells on serumpotassium level in hemodialysis patients.
    Turk J Med Sci 2017 Apr 18;47(2):407-411. Epub 2017 Apr 18.
    Department of Nephrology, Faculty of Medicine, Bezmialem Vakıf University, İstanbul, Turkey.
    Background/aim: This study aimed to compare washed red blood cell (WRBC) transfusion versus nonwashed RBC (NWRBC) transfusion in terms of posttransfusion potassium levels in dialysis patients on a day when the patient did not receive dialysis.

    Materials And Methods: The patients were randomly assigned into two groups, i.e. Read More

    Compared effects of calcium and sodium polystyrene sulfonate on mineral and bone metabolism and volume overload in pre-dialysis patients with hyperkalemia.
    Clin Exp Nephrol 2017 Apr 18. Epub 2017 Apr 18.
    Division of Nephrology, Department of Medicine, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, Japan.
    Background: Hyperkalemia is prevalent in end-stage renal disease patients, being involved in life-threatening arrhythmias. Although polystyrene sulfonate (PS) is commonly used for the treatment of hyperkalemia, direct comparison of effects between calcium and sodium PS (CPS and SPS) on mineral and bone metabolism has not yet been studied.

    Methods: In a randomized and crossover design, 20 pre-dialysis patients with hyperkalemia (>5 mmol/l) received either oral CPS or SPS therapy for 4 weeks. Read More

    Spontaneous tumor lysis syndrome in a patient with metastatic prostate cancer.
    Mol Clin Oncol 2017 Apr 8;6(4):589-592. Epub 2017 Mar 8.
    Department of Medicine, VA Palo Alto Health Care System, Palo Alto, CA 94304, USA.
    Tumor lysis syndrome (TLS) is a life-threatening oncological emergency, with most cases occurring in hematological malignancies following the initiation of treatment. However, on rare occasions, TLS may occur in solid tumors as well. In the present case study, the case is reported of a 56-year-old African-American man who presented with a recent diagnosis of prostate cancer, abdominal pain, elevated transaminases, renal insufficiency, hyperkalemia, and hyperuricemia, consistent with spontaneous TLS in the setting of metastatic prostate cancer. Read More

    [Safe treatment of acute hyperkalemia : The 1:4 and other principles].
    Anaesthesist 2017 Apr 13. Epub 2017 Apr 13.
    Klinik für Anästhesiologie, Klinikum der Universität München, Marchioninistr. 15, 81337, München, Deutschland.
    Acute hyperkalemia is a dangerous electrolyte disorder, which must be treated immediately. It can lead to cardiac arrhythmia and death due to alterations in cell membrane potentials. The resulting alterations in the electrocardiogram (ECG) are multifarious and need to be rapidly recognized. Read More

    Increased Intracranial Pressure during Hemodialysis in a Patient with Anoxic Brain Injury.
    Case Rep Crit Care 2017 20;2017:5378928. Epub 2017 Mar 20.
    Department of Neuroanaesthesiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
    Dialysis disequilibrium syndrome (DDS) is a serious neurological complication of hemodialysis, and patients with acute brain injury are at increased risk. We report a case of DDS leading to intracranial hypertension in a patient with anoxic brain injury and discuss the subsequent dialysis strategy. A 13-year-old girl was admitted after prolonged resuscitation from cardiac arrest. Read More

    Effect of Intravenous Small-Volume Hypertonic Sodium Bicarbonate, Sodium Chloride, and Glucose Solutions in Decreasing Plasma Potassium Concentration in Hyperkalemic Neonatal Calves with Diarrhea.
    J Vet Intern Med 2017 May 13;31(3):907-921. Epub 2017 Apr 13.
    Bavarian Animal Health Service (Tiergesundheitsdienst Bayern e.V.), Poing, Germany.
    Background: Hyperkalemia is a frequently observed electrolyte imbalance in dehydrated neonatal diarrheic calves that can result in skeletal muscle weakness and life-threatening cardiac conduction abnormalities and arrhythmias.

    Hypothesis: Intravenous administration of a small-volume hypertonic NaHCO3 solution is clinically more effective in decreasing the plasma potassium concentration (cK) in hyperkalemic diarrheic calves than hypertonic NaCl or glucose solutions.

    Animals: Twenty-two neonatal diarrheic calves with cK >5. Read More

    Efficacy and Safety of Patiromer in Hyperkalemia.
    J Pharm Pract 2017 Jan 1:897190017692921. Epub 2017 Jan 1.
    2 Department of Biostatistics, Christian Medical College, Vellore, Tamil Nadu, India.
    Background: Patients at the highest risk of hyperkalemia are those with chronic kidney disease (CKD) stages 3 and 4.

    Objective: To evaluate the efficacy and safety of patiromer in hyperkalemia in patients with heart failure or CKD.

    Methods: The Cochrane Renal Group's Specialized Register was searched through contact with the Trials' Search Coordinator. Read More

    Anesthetic Management of Mitochondrial Encephalopathy With Lactic Acidosis and Stroke-Like Episodes (MELAS Syndrome) in a High-Risk Pregnancy: A Case Report.
    A A Case Rep 2017 Apr 10. Epub 2017 Apr 10.
    From the *Department of Anesthesiology, University of Toronto; and †Department of Anesthesia and Pain Management, Mount Sinai Hospital, Toronto, Ontario, Canada.
    MELAS syndrome (mitochondrial encephalopathy, lactic acidosis, and stroke-like symptoms) is a rare and complex mitochondrial disorder. We present the in-hospital course of a 36-year-old gravida 2, para 0 with MELAS syndrome and severe preeclampsia, complicated by hyponatremia, hyperkalemia, and diabetes. A retained placenta with postpartum hemorrhage required urgent instrumental delivery under spinal anesthesia, transfusion, and intensive care unit admission for pulmonary edema, effusions, and atelectasis. Read More

    Dobutamine Stress Echocardiography: Impact of Abnormal Blood Potassium Levels on Cardiac Arrhythmias.
    J Am Soc Echocardiogr 2017 Jun 7;30(6):595-601. Epub 2017 Apr 7.
    Division of Cardiovascular Ultrasound, Department of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota. Electronic address:
    Background: Guidelines suggest that an abnormal blood potassium level is a relative contraindication to performing dobutamine stress echocardiography (DSE). However, this has not been previously studied.

    Methods: We reviewed a consecutive series of patients who had potassium testing within 48 hours of undergoing DSE for the evaluation of myocardial ischemia over a 10-year period (N = 13,198). Read More

    Spironolactone effect on potassium supplementation in paediatric cardiac intensive care patients.
    J Clin Pharm Ther 2017 Apr 5. Epub 2017 Apr 5.
    Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA.
    What Is Known: Spironolactone is used in paediatric patients with heart disease, yet few data are available regarding the impact on potassium supplementation.

    Objective: We sought to determine the effect of spironolactone on potassium supplementation in paediatric cardiac intensive care patients.

    Methods: A retrospective, propensity matched cohort study was designed. Read More

    Comorbidities in Heart Failure.
    Handb Exp Pharmacol 2017 Apr 6. Epub 2017 Apr 6.
    Department of Cardiology, University Medical Center Groningen, P.O. Box 30.001, 9700 RB, Groningen, The Netherlands.
    Comorbidities frequently accompany chronic heart failure (HF), contributing to increased morbidity and mortality, and an impaired quality of life. We describe the prevalence of several high-impact comorbidities in chronic HF patients and their impact on morbidity and mortality. Furthermore, we try to explain the underlying pathophysiological processes and the complex interaction between chronic HF and specific comorbidities. Read More

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