Electrolyte and Blood Pressure最新文献

A Case of Recurrent Renal Infarction Following Transient Resolution: Evidence From Serial Computed Tomography. 短暂缓解后复发的肾梗塞病例：连续计算机断层扫描的证据

Electrolyte and Blood Pressure Pub Date : 2024-06-01 Epub Date: 2024-06-27 DOI: 10.5049/EBP.2024.22.1.16

In Hong Choi, Chang Seong Kim, Eun Hui Bae, Seong Kwon Ma, Soo Wan Kim, Hong Sang Choi

{"title":"A Case of Recurrent Renal Infarction Following Transient Resolution: Evidence From Serial Computed Tomography.","authors":"In Hong Choi, Chang Seong Kim, Eun Hui Bae, Seong Kwon Ma, Soo Wan Kim, Hong Sang Choi","doi":"10.5049/EBP.2024.22.1.16","DOIUrl":"10.5049/EBP.2024.22.1.16","url":null,"abstract":"Although renal infarction (RI) is not a rare disease, its outcomes have not been well-documented. Furthermore, transient resolution and recurrence of RI have not been captured through imaging. We report a case of idiopathic RI that recurred within a short period following transient resolution, as demonstrated by serial computed tomography (CT). A 53-year-old man diagnosed with RI was transferred to the emergency room. An abdominal CT scan at the local hospital revealed a segmental wedge-shaped perfusion defect in the left kidney and a focal thrombotic filling defect in the anterior segmental branch of the left renal artery. Since his left flank pain improved, another CT scan was performed again 6 hours after the initial CT scan. A repeat CT scan showed that the thrombus in the renal artery remained, but the perfusion defect had spontaneously resolved. We initiated anticoagulant therapy using unfractionated heparin. On the sixth day of hospitalization, the left flank pain recurred, prompting another CT scan. The follow-up CT scan confirmed that RI had recurred in the same area as before. We continued anticoagulant therapy and switched to warfarin. After treatment, his symptoms improved, and he was discharged. RI can recur at any time, even after it has spontaneously resolved, as evidenced by our case. Therefore, it is crucial to closely monitor patients who experience resolution of RI for any recurrence of symptoms, and repeat radiological evaluation should be performed even within a short period.","PeriodicalId":35352,"journal":{"name":"Electrolyte and Blood Pressure","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11214911/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141493647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Use of Fludrocortisone for Hyperkalemia in Chronic Kidney Disease Not Yet on Dialysis. 使用氟氢可的松治疗尚未透析的慢性肾病患者的高钾血症。

Electrolyte and Blood Pressure Pub Date : 2024-06-01 Epub Date: 2024-06-27 DOI: 10.5049/EBP.2024.22.1.8

Eun Kyoung Lee, Won Seok Yang

{"title":"Use of Fludrocortisone for Hyperkalemia in Chronic Kidney Disease Not Yet on Dialysis.","authors":"Eun Kyoung Lee, Won Seok Yang","doi":"10.5049/EBP.2024.22.1.8","DOIUrl":"10.5049/EBP.2024.22.1.8","url":null,"abstract":"Background: Hyperkalemia is a frequent and potentially lethal complication of chronic kidney disease (CKD). We retrospectively examined the potassium-lowering effect of oral fludrocortisone and its adverse effects in hyperkalemic CKD patients not yet on dialysis.Methods: Thirty-three patients (23 men and 10 women, ages 69±14 years) were included. To control hyperkalemia at the outpatient clinic, twenty-one patients (Group 1) received fludrocortisone (0.05-0.1 mg/day) without changes in angiotensin II receptor blockers (ARBs) and calcium polystyrene sulfonate (CPS), while twelve patients (Group 2) were treated with fludrocortisone in addition to stopping ARBs and/or adding low-dose CPS.Results: Fludrocortisone was administered for a median of 169 days (interquartile range, 47-445). At the first follow-up after fludrocortisone administration, serum potassium dropped from 6.14±0.32 mEq/L to 4.52±1.06 mEq/L (p<0.001) in Group 1 and from 6.37±0.35 mEq/L to 4.08±0.74 mEq/L (p<0.01) in Group 2. Ten patients in Group 1 and five patients in Group 2 measured serum potassium levels at four outpatient visits before and after fludrocortisone administration, respectively. The frequency of serum potassium ≥6.0 mEq/L decreased from 19/40 (48%) to 2/40 (5%) (p<0.001) in Group 1 and from 11/20 (55%) to 0/20 (0%) (p<0.001) in Group 2. Eleven patients experienced sodium retention-related problems after fludrocortisone administration: 7 with worsening leg edema, 2 with pleural effusions, and 2 with pulmonary edema.Conclusion: In pre-dialysis CKD patients, fludrocortisone at low doses effectively reduced serum potassium levels; however, sodium retention was a common adverse effect.","PeriodicalId":35352,"journal":{"name":"Electrolyte and Blood Pressure","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11214912/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141493649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Is Renal Denervation Effective in Treating Resistant Hypertension? 肾脏去神经化对治疗顽固性高血压有效吗？

Electrolyte and Blood Pressure Pub Date : 2024-06-01 Epub Date: 2024-06-27 DOI: 10.5049/EBP.2024.22.1.1

Ji Hye Kim, Soon Kil Kwon

{"title":"Is Renal Denervation Effective in Treating Resistant Hypertension?","authors":"Ji Hye Kim, Soon Kil Kwon","doi":"10.5049/EBP.2024.22.1.1","DOIUrl":"10.5049/EBP.2024.22.1.1","url":null,"abstract":"Resistant hypertension is diagnosed in patients whose blood pressure target is unmet despite the use of three or more antihypertensive medications. Systemic sympathetic hyperactivation is associated with the development of resistant hypertension. As the kidney is largely pervasive of the sympathetic nervous system renal denervation procedure was developed to control blood pressure by attenuating the renal and systemic sympathetic hyperactivity. Renal denervation is a minimally invasive procedure that uses radiofrequency or ultrasound energy waves to reduce the activity of the renal artery nerves. Previous clinical trials have shown conflicting results regarding the efficacy of the procedure. Symplicity HTN-1 and -2 trials showed effective blood pressure lowering results in the renal denervation group with a good safety profile. However, the Symplicity HTN-3 trial showed no difference in blood pressure lowering effect between the renal denervation and control Sham procedure groups. Notwithstanding, some recent clinical trials with Sham control and meta-analysis showed clinical benefits of renal denervation. Other clinical benefits of renal denervation include glucose control, cardiovascular protective effect, reduction of obstructive sleep apnea, and neuralgia control. A subset of patients with satisfactory blood pressure control response to the procedure may experience improved glucose control due to the overall reduced sympathetic activity and insulin resistance. Sympathetic activity control after renal denervation has cardioprotective effects, especially for those with arrhythmia and left ventricular hypertrophy. Also, renal denervation could be helpful in renalorigin pain control. Renal denervation is an effective, safe, non-invasive procedure with many clinical benefits beyond blood pressure control. Further development in the procedure technique and selection of target patients are needed for wider clinical use of renal denervation in resistant hypertension.","PeriodicalId":35352,"journal":{"name":"Electrolyte and Blood Pressure","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11214910/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141493648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The Association Among Post-hemodialysis Blood Pressure, Nocturnal Hypertension, and Cardiovascular Risk Factors. 血液透析后血压、夜间高血压与心血管风险因素之间的关系。

Electrolyte and Blood Pressure Pub Date : 2023-12-01 Epub Date: 2023-12-18 DOI: 10.5049/EBP.2023.21.2.53

Hyunjeong Cho, Soon Kil Kwon, Seung Woo Lee, Yu Mi Yang, Hye Young Kim, Sun Moon Kim, Tae-Young Heo, Chang Hwan Seong, Kyeong Rok Kim

{"title":"The Association Among Post-hemodialysis Blood Pressure, Nocturnal Hypertension, and Cardiovascular Risk Factors.","authors":"Hyunjeong Cho, Soon Kil Kwon, Seung Woo Lee, Yu Mi Yang, Hye Young Kim, Sun Moon Kim, Tae-Young Heo, Chang Hwan Seong, Kyeong Rok Kim","doi":"10.5049/EBP.2023.21.2.53","DOIUrl":"10.5049/EBP.2023.21.2.53","url":null,"abstract":"Background: Most hemodialysis (HD) patients suffer from hypertension and have a heightened cardiovascular risk. While blood pressure (BP) control is essential to end-stage kidney disease (ESKD) patients, overly stringent control can lead to intradialytic hypotension (IDH). This study aimed to examine BP variations during and after HD to determine whether these variations correlate with IDH risk.Methods: BP measurements during dialysis were taken from 28 ESKD patients, and ambulatory BP monitoring was applied post-dialysis. Laboratory parameters and risk factors, including diabetes, coronary disease, and LV mass index, were compared between IDH and non-IDH groups using an independent t-test.Results: Of the 28 patients with an average age of 57.4 years, 16 (57.1%) had diabetes, 5 (17.9%) had coronary artery disease, and 1 (3.6%) had cerebrovascular disease. The mean systolic blood pressure (SBP) during and post-HD was 142.26 mmHg and 156.05 mmHg, respectively (p=0.0003). Similarly, the mean diastolic blood pressure (DBP) also demonstrated a significant increase, from 74.59 mmHg during HD to 86.82 mmHg post-HD (p<0.0001). Patients with IDH exhibited a more substantial SBP difference (delta SBP, 36.38 vs. 15.07 mmHg, p=0.0033; age-adjusted OR=1.58, p=0.0168) and a lower post-dialysis BUN level (12.75 vs. 18.77 mg/dL, p=0.0015; age-adjusted OR=0.76, p=0.0242). No significant variations were observed in daytime and nocturnal BP between the IDH and non-IDH groups.Conclusion: Hemodialysis patients exhibited a marked increase in post-dialysis BP and lacked a nocturnal BP dip, suggesting augmented cardiovascular risks. This highlights the importance of more stringent BP control after hemodialysis.","PeriodicalId":35352,"journal":{"name":"Electrolyte and Blood Pressure","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10751209/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139049453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Fatal Hypermagnesemia in Patients Taking Magnesium Hydroxide. 服用氢氧化镁的患者出现致命的高镁血症。

Electrolyte and Blood Pressure Pub Date : 2023-12-01 Epub Date: 2023-12-18 DOI: 10.5049/EBP.2023.21.2.66

Da Hye Jou, Su In Kim, In Hong Choi, Su Hyun Song, Tae Ryom Oh, Sang Heon Suh, Hong Sang Choi, Chang Seong Kim, Soo Wan Kim, Eun Hui Bae, Seong Kwon Ma

{"title":"Fatal Hypermagnesemia in Patients Taking Magnesium Hydroxide.","authors":"Da Hye Jou, Su In Kim, In Hong Choi, Su Hyun Song, Tae Ryom Oh, Sang Heon Suh, Hong Sang Choi, Chang Seong Kim, Soo Wan Kim, Eun Hui Bae, Seong Kwon Ma","doi":"10.5049/EBP.2023.21.2.66","DOIUrl":"10.5049/EBP.2023.21.2.66","url":null,"abstract":"Hypermagnesemia is a rare but potentially fatal electrolyte disorder often overlooked because of its unfamiliarity. Magnesium is regulated through a balance of bone, intestinal absorption, and renal excretion. Hypermagnesemia typically arises from excessive magnesium intake or reduced renal excretion; however, it also occurs in patients with normal kidney function. Herein, we report two cases of hypermagnesemia in patients taking magnesium hydroxide for constipation. The first case involved an 82-year-old woman with end-stage renal disease who developed metabolic encephalopathy due to hypermagnesemia, after taking 3,000 mg of magnesium hydroxide daily for constipation. Her magnesium level was 9.9 mg/dL. Her treatment involved discontinuing magnesium hydroxide and continuing hemodialysis, which led to her recovery. In the second case, a 50-year-old woman with a history of cerebral hemorrhage and mental retardation developed hypermagnesemia despite having normal renal function. She was also taking magnesium hydroxide for constipation, and her magnesium level was 11.0 mg/dL. She experienced cardiac arrest while preparing for continuous renal replacement therapy (CRRT). After achieving return of spontaneous circulation, CRRT was initiated, and her magnesium level showed a decreasing trend. However, vital signs and lactate levels did not recover, leading to death. These cases highlight the importance of prompt diagnosis and intervention for hypermagnesemia and the need to regularly monitor magnesium levels in individuals receiving magnesium-containing preparations, especially those with impaired kidney function.","PeriodicalId":35352,"journal":{"name":"Electrolyte and Blood Pressure","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10751210/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139049437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The Efficacy of Single-pill Combination of Olmesartan Medoxomil and Amlodipine Besylate on Office Blood Pressure in Hypertensive Patients who did not Respond to Amlodipine Besylate Monotherapy. 奥美沙坦酯和苯磺酸氨氯地平单药复方制剂对苯磺酸氨氯地平单药治疗无效的高血压患者办公室血压的疗效。

Electrolyte and Blood Pressure Pub Date : 2023-12-01 Epub Date: 2023-12-18 DOI: 10.5049/EBP.2023.21.2.45

Byong-Kyu Kim

{"title":"The Efficacy of Single-pill Combination of Olmesartan Medoxomil and Amlodipine Besylate on Office Blood Pressure in Hypertensive Patients who did not Respond to Amlodipine Besylate Monotherapy.","authors":"Byong-Kyu Kim","doi":"10.5049/EBP.2023.21.2.45","DOIUrl":"10.5049/EBP.2023.21.2.45","url":null,"abstract":"Background: As combination therapy, switching to single-pill combination (SPC) medication after a short period of monotherapy is helpful because reducing pill numbers can improve patients' adherence to medications. This study was aimed to assess the effect of the single-pill combination (SPC) of olmesartan medoxomil 20 mg and amlodipine besylate 5mg (OLM 20 mg/AML 5 mg) on blood pressure (BP) reduction in hypertensive patients who did not respond to amlodipine besylate 5 mg (AML 5 mg) monotherapy for 4 weeks.Methods: This study was a prospective, open-label, multi-center, non-comparative study. Patients whose BP was not got the target BP (≥140 mmHg and if diabetic patients ≥130 mmHg) after 4 weeks treatment with AML 5 mg, were enrolled. AML 5 mg was switched to the SPC (OLM 20 mg/AML 5 mg) treatment for 8 weeks. The primary effectiveness endpoint was the reduction of seated systolic blood pressure (SeSBP) after SPC (OLM 20 mg/AML 5 mg) treatment for 8 weeks. The changes of brachial-ankle pulse wave velocity (baPWV), central BP (CBP), and augmentation index (AIx@75) were evaluated also.Results: Forty-seven patients were enrolled (mean age = 52±9 years, 36 men). After the SPC treatment for 8 weeks, SeSBP was reduced from 153±9 mmHg to 131±18 mmHg and seated diastolic BP (SeDBP) from 95±8 mmHg to 81±11 mmHg (p<0.001 and p<0.001, respectively). The reduction of SeSBP/SeDBP were 22 mmHg and 14 mmHg, respectively. The target goal BP achievement rate was 74.5%, and baPWV, CBP, and AIx@75 were improved.Conclusion: SPC (OLM 20 mg/AML 5 mg) treatment for 8 weeks was effective in reducing BP, achieving target BP goal, and also improving arterial stiffness in uncontrolled hypertensive patients with AML 5 mg monotherapy.","PeriodicalId":35352,"journal":{"name":"Electrolyte and Blood Pressure","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10751208/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139049454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Osmotic Demyelination Syndrome in a High-Risk Patient Despite Cautious Correction of Hyponatremia. 一名高危患者在谨慎纠正低钠血症后仍出现渗透性脱髓鞘综合征

Electrolyte and Blood Pressure Pub Date : 2023-12-01 Epub Date: 2023-12-18 DOI: 10.5049/EBP.2023.21.2.61

Cheolgu Hwang

{"title":"Osmotic Demyelination Syndrome in a High-Risk Patient Despite Cautious Correction of Hyponatremia.","authors":"Cheolgu Hwang","doi":"10.5049/EBP.2023.21.2.61","DOIUrl":"10.5049/EBP.2023.21.2.61","url":null,"abstract":"Hyponatremia is a common electrolyte disorder requiring careful management to prevent severe complications. Osmotic demyelination syndrome (ODS) is a serious neurological disorder that can develop from rapid correction of hyponatremia. Herein, is a description of the case of a 61-year-old man with multiple risk factors, including alcoholism, hypokalemia, malnutrition, and alcoholic liver cirrhosis, who developed ODS despite adherence to the recommended correction rate for hyponatremia. The patient presented to the emergency department with generalized weakness, gait disturbance, and decreased muscle strength. Initial laboratory investigations revealed severe hyponatremia, hypokalemia, and dehydration. The patient was treated with cautious correction of the hyponatremia below 8 mmol/L per day. However, on the seventh hospital day, he developed tremors, rigidity, and decreased consciousness and was diagnosed with osmotic demyelination syndrome. Despite receiving general supportive care, desmopressin, and dextrose 5% in water to reduce the serum sodium levels, the patient did not show significant improvement and was transferred to a nursing home for long-term conservative care on day 35 of hospitalization. This case report highlights the challenges associated with the diagnosis and management of osmotic demyelination syndrome and the importance of identifying patients at high risk of developing this neurological disorder.","PeriodicalId":35352,"journal":{"name":"Electrolyte and Blood Pressure","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10751207/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139049451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Pseudo-Gitelman Syndrome Presenting with Hypokalemic Metabolic Alkalosis and Hypocalciuria. 出现低钾代谢性碱中毒和低钙尿的假性吉特曼综合征。

Electrolyte and Blood Pressure Pub Date : 2023-12-01 Epub Date: 2023-12-18 DOI: 10.5049/EBP.2023.21.2.72

Seung Heon Lee, Sukyung Lee, Hyunsung Kim, Gheun-Ho Kim

{"title":"Pseudo-Gitelman Syndrome Presenting with Hypokalemic Metabolic Alkalosis and Hypocalciuria.","authors":"Seung Heon Lee, Sukyung Lee, Hyunsung Kim, Gheun-Ho Kim","doi":"10.5049/EBP.2023.21.2.72","DOIUrl":"10.5049/EBP.2023.21.2.72","url":null,"abstract":"Pseudo-Bartter syndrome is a well-known differential diagnosis that needs to be excluded in cases of normotensive hypokalemic metabolic alkalosis. Pseudo-Bartter syndrome and pseudo-Gitelman syndrome are often collectively referred to as pseudo-Bartter/Gitelman syndrome; however, pseudo-Gitelman syndrome should be considered as a separate entity because Gitelman syndrome is characterized by hypocalciuria and hypomagnesemia, while Bartter syndrome is usually associated with hypercalciuria. Herein, we report the cases of two young adult female patients who presented with severe hypokalemic metabolic alkalosis, hypocalciuria, and hypomagnesemia. Diuretic or laxative abuse and self-induced vomiting were absent, and a chloride deficit and remarkable bicarbonaturia were observed. Initial sequencing studies for SLC12A3, CLCKNB, and KCNJ10 revealed no mutations, and whole-exome sequencing revealed no pathogenic variants. The metabolic alkalosis was saline-responsive in one case, and steroid therapy was necessary in the other to relieve chronic tubulointerstitial nephritis, which was diagnosed with kidney biopsy. A new category of pseudo-Gitelman syndrome should be defined, and various etiologies should be investigated.","PeriodicalId":35352,"journal":{"name":"Electrolyte and Blood Pressure","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10751206/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139049452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Hidden Acid Retention with Normal Serum Bicarbonate Level in Chronic Kidney Disease. 慢性肾病患者血清碳酸氢盐水平正常的隐性酸潴留。

Electrolyte and Blood Pressure Pub Date : 2023-06-01 DOI: 10.5049/EBP.2023.21.1.34

Eun Sil Koh

{"title":"Hidden Acid Retention with Normal Serum Bicarbonate Level in Chronic Kidney Disease.","authors":"Eun Sil Koh","doi":"10.5049/EBP.2023.21.1.34","DOIUrl":"https://doi.org/10.5049/EBP.2023.21.1.34","url":null,"abstract":"Management of metabolic acidosis is crucial for preserving bone, muscle, and renal health, as evidenced by the results of several interventional studies conducted on patients with chronic kidney disease (CKD). Considering the continuity of CKD progression over time, it is reasonable to deduce that a subclinical form of metabolic acidosis may exist prior to the manifestation of overt metabolic acidosis. Covert H+ retention with normal serum bicarbonate level in patients with CKD may result in maladaptive responses that contribute to kidney function deterioration, even in the early stages of the disease. The loss of adaptive compensatory mechanisms of urinary acid excretion may be a key factor in this process. Early modulation of these responses could be an important therapeutic strategy in preventing CKD progression. However, to date, the optimal approach for alkali therapy in subclinical metabolic acidosis in CKD remains uncertain. There is a lack of established guidelines on when to initiate alkali therapy, potential side effects of alkali agents, and the optimal blood bicarbonate levels based on evidence-based practices. Therefore, further research is necessary to address these concerns and establish more robust guidelines for the use of alkali therapy in patients with CKD. Herein, we provide an overview of recent developments on this subject and examine the potential therapeutic approaches that interventional treatments may present for patients with hidden H+ retention, exhibiting normal serum bicarbonate levels - commonly described as subclinical or eubicarbonatemic metabolic acidosis in patients with CKD.","PeriodicalId":35352,"journal":{"name":"Electrolyte and Blood Pressure","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ac/0c/ebp-21-34.PMC10329907.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9814476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Erratum: Management for Electrolytes Disturbances during Continuous Renal Replacement Therapy. 勘误:持续肾替代治疗期间电解质紊乱的处理。

Electrolyte and Blood Pressure Pub Date : 2023-06-01 DOI: 10.5049/EBP.2023.21.1.44

Song In Baeg, Kyungho Lee, Junseok Jeon, Hye Ryoun Jang

引用次数: 0