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    Hypokalemia: A potentially life-threatening complication of tenofovir therapy.
    SAGE Open Med Case Rep 2017 14;5:2050313X17741010. Epub 2017 Nov 14.
    Division of Nephrology, Hypertension and Renal Transplantation, University of Florida, Gainesville, FL, USA.
    Tenofovir is a nucleotide analog reverse transcriptase inhibitor approved for the treatment of HIV and hepatitis B infections. It is widely prescribed and an integral part of the recommended regimens for the treatment of HIV infection in antiretroviral-naive patients. Tenofovir is implicated in renal proximal tubular dysfunction, which can be associated with Fanconi syndrome and hypokalemia. Read More

    Liposomal amphotericin B in travelers with cutaneous and muco-cutaneous leishmaniasis: Not a panacea.
    PLoS Negl Trop Dis 2017 Nov 20;11(11):e0006094. Epub 2017 Nov 20.
    INTS, Unité Biologie Intégrée du Globule Rouge, Laboratoire d'Excellence GR-Ex, Centre d'Infectiologie Necker-Pasteur, Institut Pasteur, Paris, France.
    Background: Complex cutaneous and muco-cutaneous leishmaniasis (CL and MCL) often requires systemic therapy. Liposomal amphotericin B (L-AmB) has a strong potential for a solid clinical benefit in this indication.

    Methods: We conducted a retrospective analysis of data from a French centralized referral treatment program and from the "LeishMan" European consortium database. Read More

    Determinants and Outcome of Metabolic Acidosis in Diarrheal Children Under 5 Years of Age in an Urban Critical Care Ward in Bangladesh.
    Glob Pediatr Health 2017 7;4:2333794X17740223. Epub 2017 Nov 7.
    International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh.
    We evaluated the independent determinants and outcome of metabolic acidosis in diarrheal children. Children under 5 years of age admitted with diarrhea and severe respiratory distress in the critical care ward at Dhaka Hospital of icddr,b (International Centre for Diarrhoeal Disease Research, Bangladesh) from April 2010 to April 2014 who had their reports of arterial blood gas analyses were enrolled in the study. We compared clinical and laboratory characteristics between the study children with (cases = 74) and without metabolic acidosis (controls = 65). Read More

    Acid-base alterations in ESRD and effects of hemodialysis.
    Semin Dial 2017 Nov 16. Epub 2017 Nov 16.
    Division of Nephrology and Hypertension, Department of Medicine, Mayo Clinic College of Medicine, Rochester, MN, USA.
    Acid-base alterations in patients with kidney failure and on hemodialysis (HD) treatment contribute to (1) intradialytic hypercapnia and hypoxia, (2) hemodynamic instability and cardiac arrhythmia, (3) systemic inflammation, and (4) a number of associated electrolyte alterations including potentiating effects of hypokalemia, hypocalcemia and, chronically, soft-tissue and vascular calcification, imparting poor prognosis and mortality. This paper discusses acid-base regulation and pathogenesis of dysregulation in patients with kidney failure. Major organ and systemic effects of acid-base perturbations with a specific focus on kidney failure patients on HD are emphasized, and potential mitigating strategies proposed. Read More

    Is Primary Aldosteronism Still Largely Unrecognized?
    Horm Metab Res 2017 Nov 16. Epub 2017 Nov 16.
    Division of Internal Medicine and Hypertension Unit, Department of Medical Sciences, University of Torino, Torino, Italy.
    Primary aldosteronism (PA) was first reported by Jerome W. Conn in 1954 when it was considered a rare disorder, only suspected in cases of hypertension and spontaneous hypokalemia. Over the last 30 years, with the wide application of the plasma aldosterone to plasma renin activity ratio as screening test, the clinical spectrum of PA has dramatically changed. Read More

    17α-HYDROXYLASE DEFICIENCY IS AN UNDERDIAGNOSED DISEASE. HIGH FREQUENCY OF MISDIAGNOSES IN A LARGE COHORT OF BRAZILIAN PATIENTS.
    Endocr Pract 2017 Nov 16. Epub 2017 Nov 16.
    From: Division of Endocrinology and Metabolism, Department of Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo - SP, 04039-034, Brazil.
    Objective: 17α-Hydroxylase deficiency (P450c17D) is characterized by hypogonadism and mineralocorticoid hypertension. We aimed to estimate the relative incidence and spectrum of preliminary misdiagnoses in Brazilian P450c17D patients.

    Design: Cross-sectional study. Read More

    Liddle's syndrome in an African male due to a novel frameshift mutation in the beta-subunit of the epithelial sodium channel gene.
    Cardiovasc J Afr 2017 Sep 23;28(4):e4-e6. Epub 2017 Sep 23.
    Department of Medicine, Division of Nephrology and Hypertension, University of Cape Town, Cape Town, South Africa.
    Resistant hypertension is a common clinical problem in South Africa and is frequently associated with low renin and aldosterone levels, especially in black Africans. In South Africa, novel variants in the epithelial sodium channel (ENaC) have been described to be associated with varying degrees of hypokalaemia and hypertension due to primary sodium retention. We report here a case of Liddle's syndrome due to a novel c. Read More

    [Role of adrenal vein sampling in differential diagnosis of primary aldosteronism subtypes].
    Zhonghua Yi Xue Za Zhi 2017 Nov;97(42):3291-3296
    Department of Endocrinology, Drum Tower Hospital Affiliated to Nanjing University Medical School, Nanjing 210008, China.
    Objective: To investigate the role of adrenal vein sampling (AVS) in identifying the subtype of primary aldosteronism (PA). Methods: AVS was performed in 50 patients who were confirmed as PA between September 2010 and September 2016 in Nanjing Drum Tower Hospital. Clinical, biochemical and follow-up data were reviewed retrospectively. Read More

    Potassium Chloride Sustained Release Dosing Pathway in an Academic Medical Center.
    Crit Pathw Cardiol 2017 Dec;16(4):158-160
    From the Department of Pharmacy, Brigham and Women's Hospital, Boston, MA.
    Potassium supplementation can be administered intravenously or orally with either immediate release or sustained release formulations. Sustained release potassium chloride allows for delayed absorption and peak effects. In the inpatient setting, it is important to monitor and prevent both hypokalemia and hyperkalemia. Read More

    Electrolytes imbalance caused by amikacin in patients receiving multi drug resistance- tuberculosis treatment at Hazara region Kpk, Pakistan.
    Tuberk Toraks 2017 Sep;65(3):193-201
    Department of Biochemistry, Hazara University, Mansehra, KPK, Pakistan.
    Introduction: Multi drug resistance-tuberculosis (MDR-TB) is considered amongst one of the fatal medical and public health issue. Greater frequency of adverse reactions has been observed using 2nd line antituberculosis drugs, which rises the rate of morbidity. Hypokalemia and hyponatremia are common in patients receiving MDR-TB treatment. Read More

    All sorts of tests, only one question: an unexpected cause of hypertension.
    BMJ Case Rep 2017 Nov 9;2017. Epub 2017 Nov 9.
    Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
    A 48-year-old woman presented to the Accident and Emergency department with a 4 month history of headaches, nausea and dizziness. She was found to have severe hypertension and hypokalaemia. Extensive investigations did not find any secondary cause for hypertension. Read More

    Chest pain as a manifestation of hypokalemia in a pediatric patient.
    Am J Emerg Med 2017 Nov 7. Epub 2017 Nov 7.
    Valley Hospital, Department of Emergency Medicine, 223 North Van Dien Avenue, Ridgewood, NJ 07450, USA. Electronic address:
    Patients presenting to the emergency department with chest pain are common and a cause of significant concern to patients and families and physicians alike. The causes of chest pain are myriad. These causes span diverse categories including cardiovascular, respiratory, abdominal and gastrointestinal, musculoskeletal, psychiatric, hematologic and oncologic, and neurologic Thull-Freedman (2010) [1]. Read More

    Spironolactone is effective in treating hypokalemia among peritoneal dialysis patients.
    PLoS One 2017 10;12(11):e0187269. Epub 2017 Nov 10.
    Department of Medicine, Division of Nephrology, Ottawa Hospital, Ottawa, Ontario, Canada.
    Background: Hypokalemia is common in peritoneal dialysis (PD) patients and is associated with increased cardiovascular and all-cause mortality. The management approach for such patients routinely includes spironolactone at our centre. We undertook this study to assess the efficacy of spironolactone for the treatment of hypokalemia in PD patients. Read More

    Cardiac arrest caused by sibutramine obtained over the Internet: a case of a young woman without pre-existing cardiovascular disease successfully resuscitated using extracorporeal membrane oxygenation.
    Acute Med Surg 2017 Jul 29;4(3):334-337. Epub 2017 Mar 29.
    Department of Emergency MedicineSapporo Medical UniversityHokkaidoJapan.
    Case: Sibutramine is a weight loss agent that was withdrawn from the market in the USA and European Union because it increases adverse events in patients with cardiovascular diseases. However, non-prescription weight loss pills containing sibutramine can be still easily purchased over the Internet.

    A 21-year-old woman without history of cardiovascular diseases developed cardiac arrest. Read More

    Consequences of Different Corticosteroids on Serum Potassium and Prostate-Specific Antigen in Patients Receiving Abiraterone for Castration-Resistant Prostate Cancer: A Retrospective Observational Study.
    Clin Med Insights Oncol 2017 30;11:1179554917737736. Epub 2017 Oct 30.
    Department of Pharmacy, Juntendo University Nerima Hospital, Tokyo, Japan.
    Background: Abiraterone acetate is an androgen synthesis inhibitor approved for the treatment of castration-resistant prostate cancer (CRPC). Although co-administration of either prednisone or prednisolone at 10 mg/d has been recommended to reduce the risk of abiraterone-induced hyperaldosteronism (notably hypokalemia) and to give adjunctive pain relief effects, whether these glucocorticoids can be substituted by dexamethasone remains unknown.

    Methods: We performed a retrospective review of medical records of patients who were given abiraterone for the treatment of CRPC with either prednisolone (ABI/PSL) 10 mg/d or dexamethasone (ABI/DEX) 0. Read More

    Prevention of Chemotherapy-Induced Nephrotoxicity in Children with Cancer.
    Int J Prev Med 2017 5;8:76. Epub 2017 Oct 5.
    Department of Pediatrics, Division of Nephrology, Rush University Medical Center, Chicago, Illinois, USA.
    Children with cancer treated with cytotoxic drugs are frequently at risk of developing renal dysfunction. The cytotoxic drugs that are widely used for cancer treatment in children are cisplatin (CPL), ifosfamide (IFO), carboplatin, and methotrexate (MTX). Mechanisms of anticancer drug-induced renal disorders are different and include acute kidney injury (AKI), tubulointerstitial disease, vascular damage, hemolytic uremic syndrome (HUS), and intrarenal obstruction. Read More

    Risk Factors for the Development of Refeeding Syndrome-Like Hypophosphatemia in Very Low Birth Weight Infants.
    Dis Markers 2017 5;2017:9748031. Epub 2017 Sep 5.
    Department of Pediatrics, Faculty of Medical Sciences, University of Fukui, 23-3 Shimoaizuki, Matsuoka, Eiheiji-cho, Yoshida-gun, Fukui 910-1193, Japan.
    Background: Refeeding syndrome is characterized by metabolic disturbance including hypophosphatemia and hypokalemia upon reinstitution of nutrition in severely malnourished patients.

    Objective: The present study sought to identify the risk factors for the development of refeeding syndrome-like metabolic disturbance in very low birth weight infants.

    Methods: The correlations of severe hypophosphatemia with the serum levels of potassium and ionized calcium, daily calorie and phosphate intake, and umbilical cord blood flow on ultrasonography were analyzed in 49 very low birth weight infants. Read More

    Ultrasound of the diaphragm in severe hypokalemia induced diaphragmatic dysfunction.
    Lung India 2017 Nov-Dec;34(6):552-554
    Department of Critical Care Medicine, Alka Hospital Pvt. Ltd., Lalitpur, Nepal.
    Severe hypokalemia presents with significant muscle weakness and involvement of respiratory muscles. Bedside ultrasonography of the diaphragm is emerging as a noninvasive bedside tool for diagnosis and followup of diaphragmatic dysfunction due to various causes. Here, we present a case of diaphragmatic dysfunction due to severe hypokalemia. Read More

    An unusual case of Takotsubo syndrome with hyperaldosteronism as the potential cause.
    J Clin Endocrinol Metab 2017 Oct 31. Epub 2017 Oct 31.
    West China Hospital, Sichuan University.
    Context: Catecholamine-related factors are currently the most popular explanation for the occurrence of Takotsubo syndrome. The aldosterone-related mechanism, however, has not been proposed.

    Case Description: A 45-year old male, presenting with ST-segment elevation myocardial infarction (STEMI), was finally diagnosed with primary aldosteronism, severe hypokalemia, and Takotsubo syndrome. Read More

    [A case of Gitelman syndrome with physical retardation].
    Zhong Nan Da Xue Xue Bao Yi Xue Ban 2017 Oct;42(10):1236-1238
    Department of Pediatrics, Xiangya Hospital, Central South University, Changsha 410008, China.
    Gitelman syndrome is a rare disease. It is easy to be misdiagnosed and missed diagnosis due to the diverse clinical symptoms. A girl with long-term hypokalemia, who presented with intermittent pain of lower limb muscle and physical retardation, was treated in Xiangya Hospital, Central South University. Read More

    Primary Hyperaldosteronism Due to Adrenocortical Adenoma: a Case Report.
    Acta Med Indones 2017 Jul;49(3):249-254
    Department of Internal Medicine Faculty of Medicine, Diponegoro University - Dr. Kariadi Hospital Semarang, Indonesia.
    Primary hyperaldosteronism is an adrenal abnormality in which there is some degree of autonomy of aldosterone secretion. We report a case of thirty three years old Javanese female presented with uncontrolled hypertension, muscular weakness, cramps  and progressing shortness of breath during working for 6 years. She had history of hypertension since age 20. Read More

    Significance of Computed Tomography and Serum Potassium in Predicting Subtype Diagnosis of Primary Aldosteronism.
    J Clin Endocrinol Metab 2017 Oct 6. Epub 2017 Oct 6.
    Department of Endocrinology and Metabolism, National Hospital Organization Kyoto Medical Center, Kyoto, Japan.
    Context: The number of centers with established adrenal venous sampling (AVS) programs for subtype diagnosis of primary aldosteronism (PA) is limited.

    Objective: Aim was to develop an algorithm for AVS based on subtype prediction by computed tomography (CT) and serum potassium.

    Design: A multi-institutional retrospective cohort study in Japan. Read More

    Oral rehydration of malnourished children with diarrhoea and dehydration: A systematic review.
    Wellcome Open Res 2017 28;2:66. Epub 2017 Sep 28.
    KEMRI-Wellcome Trust Research Programme, Kilifi, 80108, Kenya.
    Background: Diarrhoea complicates over half of admissions to hospital with severe acute malnutrition (SAM). World Health Organization (WHO) guidelines for the management of dehydration recommend the use of oral rehydration with ReSoMal (an oral rehydration solution (ORS) for SAM), which has lower sodium (45mmols/l) and higher potassium (40mmols/l) content than old WHO ORS. The composition of ReSoMal was designed specifically to address theoretical risks of sodium overload and potential under-treatment of severe hypokalaemia with rehydration using standard ORS. Read More

    Dysregulation of Aldosterone Secretion in Mast Cell-Deficient Mice.
    Hypertension 2017 Dec 30;70(6):1256-1263. Epub 2017 Oct 30.
    From the Normandie Université, UNIROUEN, INSERM U1239, Rouen, France (H.-G.B., J.W., S.R., C.D., I.B., H.L., E.L.); Department of Pharmacology, Institute for Biomedical Research, Rouen University Hospital, France (J.W.); Normandie Université, UNIROUEN, Rouen, France (A.A.); and Department of Endocrinology, Diabetes, and Metabolic Diseases, Institute for Research and Innovation in Biomedicine, University Hospital of Rouen, France (H.L.).
    Resident adrenal mast cells have been shown to activate aldosterone secretion in rat and man. Especially, mast cell proliferation has been observed in adrenal tissues from patients with aldosterone-producing adrenocortical adenoma. In the present study, we show that the activity of adrenal mast cells is stimulated by low-sodium diet and correlates with aldosterone synthesis in C57BL/6 and BALB/c mice. Read More

    Association between hypo- and hyperkalemia and outcome in acute heart failure patients: the role of medications.
    Clin Res Cardiol 2017 Oct 28. Epub 2017 Oct 28.
    Department of Anesthesiology and Critical Care and Burn Unit, St-Louis Hospital, Assistance Publique- Hôpitaux de Paris,, Paris, France.
    Background: The interaction between chronic medications on admission and the association between serum potassium level and outcome in patients with acute heart failure (AHF) are unknown.

    Methods: Observational intercontinental study of patients admitted with AHF. 15954 patients were included from 12 cohorts in 4 continents. Read More

    Scorpion envenoming in Morona Santiago, Amazonian Ecuador: Molecular phylogenetics confirms involvement of the Tityus obscurus group.
    Acta Trop 2017 Oct 25;178:1-9. Epub 2017 Oct 25.
    Carrera de Biotecnología, Facultad de Ingenierías y Ciencias Agropecuarias, Universidad de Las Américas, Quito, Ecuador; Laboratorio de Biología Molecular de Toxinas y Receptores, Instituto de Medicina Experimental, Facultad de Medicina, Universidad Central de Venezuela, Caracas 1051, Venezuela. Electronic address:
    Scorpion envenoming by species in the genus Tityus is hereby reported from rural locations in the Amazonian province of Morona Santiago, southeastern Ecuador. Twenty envenoming cases (18 patients under 15 years of age) including one death (a 4-year-old male) were recorded at the Macas General Hospital, Morona Santiago, between January 2015 and December 2016 from the counties of Taisha (n=17), Huamboyo (n=1), Palora (n=1), and Logroño (n=1). An additional fatality from 2014 (a 3-year-old female from Nayantza, Taisha county) is also reported. Read More

    Unusual Complication of Multidrug Resistant Tuberculosis.
    Case Rep Nephrol 2017 18;2017:6835813. Epub 2017 Sep 18.
    Division of Medicine, Seth G.S. Medical College & KEM Hospital, Parel, Mumbai 400 012, India.
    Introduction: Capreomycin is a second-line drug often used for multidrug-resistant tuberculosis which can result in nephrotoxic effects similar to other aminoglycosides. We describe a case of capreomycin induced Bartter-like syndrome with hypocalcemic tetany.

    Case Report: 23-year-old female patient presented with carpopedal spasms and tingling sensations in hands. Read More

    Transient Hypokalemic Quadriplegia Following a Lumbar Transforaminal Epidural Dexamethasone Injection: A Case Report.
    PM R 2017 Oct 23. Epub 2017 Oct 23.
    University of Colorado School of Medicine, Department of Physical Medicine & Rehabilitation. Electronic address:
    A 30-year-old male with no significant past medical history presented with hypokalemic quadriplegia four hours after he received a lumbar transforaminal epidural steroid injection (TFESI) containing dexamethasone and lidocaine. A comprehensive work up ruled out acquired and hereditary causes of hypokalemic paralysis. Symptoms gradually resolved within hours after potassium restoration with no residual neurologic deficits. Read More

    The safety of high-dose insulin euglycaemia therapy in toxin-induced cardiac toxicity.
    Clin Toxicol (Phila) 2017 Oct 26:1-8. Epub 2017 Oct 26.
    a Clinical Toxicology Research Group , University of Newcastle , Newcastle , Australia.
    Context: High-dose insulin euglycaemia (HIE) is recommended in the management of toxin-induced cardiac toxicity, with increasing insulin doses now being used. We aimed to investigate the safety of HIE in toxin-induced cardiac toxicity.

    Methods: This was a retrospective review of cases from two clinical toxicology units. Read More

    Two consecutive successful live birth in woman with 17α hydroxylase deficiency by frozen-thaw embryo transfer under hormone replacement endometrium preparation.
    Gynecol Endocrinol 2017 Oct 25:1-4. Epub 2017 Oct 25.
    a Department of Obstetrics and Gynecology , Nagasaki University Graduate School of Biomedical Sciences , Nagasaki , Japan.
    17α-Hydroxylase deficiency is rare autosomal recessive disorder that manifested by hypertension, hypokalemia, delayed sexual development, primary amenorrhea and infertility. The information regarding infertility care and conception in women with this disorder are extremely limited. We report a 24-year-old Japanese woman with primary amenorrhea who was diagnosed as partial 17α-hydroxylase deficiency caused by homozygous 3 bp deletion in exon 1 of 17α-hydroxylase gene. Read More

    Hypernatremia and acute pancreatitis in chronic kidney disease: back to the salt mines. Questions.
    Pediatr Nephrol 2017 Oct 24. Epub 2017 Oct 24.
    Pediatric Nephrology Department, Robert Debré Hospital, 48 Boulevard Sérurier, 75019, Paris, France.
    Background: Acute pancreatitis can be a life-threatening complication in patients with chronic kidney disease (CKD), especially in kidney transplant recipients.

    Case Diagnosis/treatment: The patient was 7 years old when he received renal transplantation for CKD secondary to posterior urethral valves. Two years later, he presented with severe necrotizing pancreatitis (Ranson's score 5, Balthazar's score 8). Read More

    A randomized controlled trial of one bag vs. two bag system of fluid delivery in children with diabetic ketoacidosis: Experience from a developing country.
    J Crit Care 2017 Sep 22. Epub 2017 Sep 22.
    Advanced Pediatrics Centre, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India.
    Purpose: To compare one vs. two bag system with respect to blood glucose variability (BGV), time for resolution of acidosis and incidence of hypoglycemia, hypokalemia, and cerebral edema in children with diabetic ketoacidosis (DKA).

    Material And Methods: In an open labelled randomized controlled trial, thirty consecutive patients ≤12years with DKA were randomized to either one (n=15) or two bag (n=15) system of intravenous fluid delivery. Read More

    A Case of Renal Tubular Acidosis with Sjogren's Syndrome Showing Paradoxical Block of PTH Due to Severe Hypomagnesemia.
    Indian J Clin Biochem 2017 Oct 18;32(4):496-499. Epub 2016 Dec 18.
    Sundaram Medical Foundation, Dr. Rangarajan Memorial Hospital, 9C, IV Avenue, Shanthi Colony, Anna Nagar, Chennai, 600040 India.
    Distal renal tubular acidosis (RTA) manifests either as Complete/Classical form or Incomplete/Latent Form. Distal RTA causes normal anion gap metabolic acidosis and hypokalemia. Interstitial Nephritis is the most frequent renal manifestation of Sjogren's, which presents as Distal RTA in 25-40% of patients with Sjogren's syndrome. Read More

    Incidence of hyperglycemia and diabetes and association with electrolyte abnormalities in pediatric solid organ transplant recipients.
    Nephrol Dial Transplant 2017 Sep;32(9):1579-1586
    Department of Pediatrics, Division of Pediatric Nephrology, Hospital for Sick Children, Toronto, ON, Canada.
    Background: Posttransplant hyperglycemia is an important predictor of new-onset diabetes after transplantation, and both are associated with significant morbidity and mortality. Precise estimates of posttransplant hyperglycemia and diabetes in children are unknown. Low magnesium and potassium levels may also lead to diabetes after transplantation, with limited evidence in children. Read More

    Hyponatremia as the Presenting Feature of a Pituitary Abscess in a Calf.
    Vet Sci 2017 Feb 6;4(1). Epub 2017 Feb 6.
    Department of Veterinary Clinical Medicine, University of Illinois, Urbana, IL 61802, USA.
    A 2-month-old Simmental heifer presented for acute onset of neurological behavior. Laboratory tests confirmed the presence of hyponatremia, hypochloremia, and hypokalemia that improved with intravenous fluid therapy. Despite an initial cessation of neurological signs, symptoms re-emerged, and the heifer was euthanized due to poor prognosis. Read More

    Peritoneal dialysis: The unique features by compartmental delivery of renal replacement therapy.
    Med Hypotheses 2017 Oct 7;108:128-132. Epub 2017 Sep 7.
    Institute of Pathophysiology, Semmelweis University, Budapest, Hungary.
    Despite decades of research, the clinical efficacy of peritoneal dialysis (PD) remains enigmatic. We may wonder why the modality fail in some patients but perhaps the more proper question would be, why it works in so many? We know that the contribution of residual renal function (RRF), more so than in hemodialysis, is critically important to the well-being of many of the patients. Unique features of the modality include the relatively low volume of dialysate fluid needed to provide effective uremic control and the disproportionate tendency for both hypokalemia and hypoalbuminemia, when compared to hemodialysis. Read More

    Persistent severe hypokalemia: Gitelman syndrome and differential diagnosis.
    J Bras Nefrol 2017 Jul-Sep;39(3):337-340
    Universidade do Sul de Santa Catarina.
    The main causes of hypokalemia are usually evident in the clinical history of patients, with previous episodes of vomiting, diarrhea or diuretic use. However, in some patients the cause of hypokalemia can become a challenge. In such cases, two major components of the investigation must be performed: assessment of urinary excretion potassium and the acid-base status. Read More

    Renal Tubular Acidosis in Patients with Primary Sjögren's Syndrome.
    Electrolyte Blood Press 2017 Sep 30;15(1):17-22. Epub 2017 Sep 30.
    Division of Nephrology, Department of Internal Medicine, Kyung Hee University Medical Center, Seoul, Korea.
    Primary Sjögren's syndrome (pSS) is characterized by lymphocytic infiltration of the exocrine glands resulting in decreased saliva and tear production. It uncommonly involves the kidneys in various forms, including tubulointerstitial nephritis, renal tubular acidosis, Fanconi syndrome, and rarely glomerulonephritis. Its clinical symptoms include muscle weakness, periodic paralysis, and bone pain due to metabolic acidosis and electrolyte imbalance. Read More

    Drugs and life-threatening ventricular arrhythmia risk: results from the DARE study cohort.
    BMJ Open 2017 Oct 16;7(10):e016627. Epub 2017 Oct 16.
    Research Department, Drug Safety Research Unit, Southampton, UK.
    Objectives: To establish a unique sample of proarrhythmia cases, determine the characteristics of cases and estimate the contribution of individual drugs to the incidence of proarrhythmia within these cases.

    Setting: Suspected proarrhythmia cases were referred by cardiologists across England between 2003 and 2011. Information on demography, symptoms, prior medical and drug histories and data from hospital notes were collected. Read More

    [A clinical and hereditary analysis of novel complex heterozygous KCNJ1 mutation in a Bartter syndrome type Ⅱ patient].
    Zhonghua Nei Ke Za Zhi 2017 Oct;56(10):760-762
    Department of Endocrinology, Key Laboratory of Endocrinology of National Health and Family Planning Commission, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China.
    Bartter syndrome (BS) is a hereditary condition transmitted as an autosomal recessive (Bartter type 1 to 4) or dominant trait (Bartter type 5). The disease associates hypokalemic alkalosis with varying degrees of hypercalciuria. Here we presented a case (BS type Ⅱ) of a 17 years old female presented with polyhydramnios, polyuria, nephrocalcinosis and hypokalemia, which was alleviated after treatment with celecoxib and vitamin D(3). Read More

    Treatment of Abnormalities of Potassium Homeostasis in CKD.
    Adv Chronic Kidney Dis 2017 09;24(5):319-324
    Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas; and Biomedical Research Department, Diabetes and Obesity Research Division, Cedars-Sinai Medical Center, Los Angeles, California.
    Hyperkalemia, defined as serum potassium concentrations greater than 5.0 to 5.5 mEq/L, is a frequent occurrence in clinical practice because of the increasing incidence and prevalence of CKD. Read More

    Hyperkalemia and Hypokalemia in CKD: Prevalence, Risk Factors, and Clinical Outcomes.
    Adv Chronic Kidney Dis 2017 09;24(5):315-318
    Division of Nephrology, Department of Medicine, University of Utah, Salt Lake City, UT; and Nephrology Section, Veterans Affairs Salt Lake City Health Care System, Salt Lake City, UT. Electronic address:
    Abnormalities of serum potassium are common in patients with CKD. Although hyperkalemia is a well-recognized complication of CKD, the prevalence rates of hyperkalemia (14%-20%) and hypokalemia (12%-18%) are similar. CKD severity, use of medications such as renin-angiotensin-aldosterone system inhibitors and diuretics, and dietary potassium intake are major determinants of serum potassium concentration in CKD. Read More

    Regulation of Potassium Homeostasis in CKD.
    Adv Chronic Kidney Dis 2017 09;24(5):305-314
    Section on General Internal Medicine, Wake Forest School of Medicine, Winston Salem, NC, and the Division of Nephrology, University of Virginia School of Medicine, Charlottesville, VA. Electronic address:
    Disturbances of potassium homeostasis can cause either hyperkalemia or hypokalemia and result in serious consequences. Although the consequences of acute and chronic hyperkalemia and treatment of these conditions in CKD have been widely appreciated by nephrologists, more recent information has focused attention on the consequences of chronic hypokalemia. Several recent studies have documented a "U-shaped" relationship between the serum [K(+)] and higher mortality in several clinical studies. Read More

    Potassium homeostasis in health and disease: A scientific workshop cosponsored by the National Kidney Foundation and the American Society of Hypertension.
    J Am Soc Hypertens 2017 Oct 10. Epub 2017 Oct 10.
    Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
    While much emphasis, and some controversy, centers on recommendations for sodium intake, there has been considerably less interest in recommendations for dietary potassium intake, in both the general population and patients with medical conditions, particularly acute and chronic kidney disease. Physiology literature and cohort studies have noted that the relative balance in sodium and potassium intakes is an important determinant of many of the sodium-related outcomes. A noteworthy characteristic of potassium in clinical medicine is the extreme concern shared by many practitioners when confronted by a patient with hyperkalemia. Read More

    Anesthetic considerations in a parturient with renal tubular acidosis and hypothyroidism undergoing cesarean delivery.
    Int J Obstet Anesth 2017 Aug 31. Epub 2017 Aug 31.
    Department of Anesthesia and Intensive Care, Dr. Sampurnanand Medical College, Jodhpur 342003, India.
    Renal tubular acidosis, associated with hypothyroidism, is rare. We present the case of a woman with known renal tubular acidosis and treated hypothyroidism who underwent emergency cesarean delivery under uneventful combined spinal-epidural anesthesia. The rationale for choosing the anesthetic technique and the potential risks associated with anesthesia and renal tubular acidosis are discussed. Read More

    Potassium Homeostasis in Health and Disease: A Scientific Workshop Cosponsored by the National Kidney Foundation and the American Society of Hypertension.
    Am J Kidney Dis 2017 Sep 29. Epub 2017 Sep 29.
    Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
    While much emphasis, and some controversy, centers on recommendations for sodium intake, there has been considerably less interest in recommendations for dietary potassium intake, in both the general population and patients with medical conditions, particularly acute and chronic kidney disease. Physiology literature and cohort studies have noted that the relative balance in sodium and potassium intakes is an important determinant of many of the sodium-related outcomes. A noteworthy characteristic of potassium in clinical medicine is the extreme concern shared by many practitioners when confronted by a patient with hyperkalemia. Read More

    Long-Term Potassium Monitoring and Dynamics in Heart Failure and Risk of Mortality.
    Circulation 2017 Oct 12. Epub 2017 Oct 12.
    Cardiology Department, Hospital Clínico Universitario de Valencia, INCLIVA, Departamento de Medicina, Universitat de València, Valencia, Spain & CIBER in Cardiovascular Diseases (CIBERCV), Madrid, Spain.
    Background -The prognostic value of long-term potassium monitoring and dynamics in heart failure (HF) has not been characterized completely. We sought to determine the association between serum potassium values collected at follow-up with all-cause mortality in a prospective and consecutive cohort of patients discharged from a previous acute HF admission. Methods -Serum potassium was measured at every physician-patient encounter, including hospital admissions and ambulatory settings. Read More

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