{"title":"V2 receptor antagonist; tolvaptan.","authors":"Joo-Hark Yi, Hyun-Jong Shin, Ho-Jung Kim","doi":"10.5049/EBP.2011.9.2.50","DOIUrl":"https://doi.org/10.5049/EBP.2011.9.2.50","url":null,"abstract":"<p><p>Hyponatremia is the most common electrolyte disorder in hospitalized patients. Many studies documented that it was related to increased morbidity and mortality in patients with congestive heart failure, liver cirrhosis, and neurologic diseases. Although knowledge of hyponatremia has been cumulated, the optimal management of hyponatremia remains incompletely established in clinical practice because of the diversity of underlying disease states, and its multiple causes with differing pathophysiologic mechanisms. Since vasopressin receptor antagonists have unique aquaretic effect to selectively increase electrolytes-free water excretion, clinicians could apply a more effective method to treat hyponatremia. Tolvaptan has significant evidence that it improves serum sodium levels in patients with euvolemic or hypervolemic hyponatremia related with heart failure, cirrhosis or syndrome of inappropriate anti-diuretic hormone. Tolvaptan has acceptable safety and tolerability for long-term usage in chronic hyponatremia, and the beneficial effects on serum Na(+) occurred in patients with both mild and marked hyponatremia.</p>","PeriodicalId":35352,"journal":{"name":"Electrolyte and Blood Pressure","volume":"9 2","pages":"50-4"},"PeriodicalIF":0.0,"publicationDate":"2011-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5049/EBP.2011.9.2.50","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30520681","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}
{"title":"Effects of dietary salt restriction on puromycin aminonucleoside nephrosis: preliminary data.","authors":"Chor Ho Jo, Sua Kim, Joon-Sung Park, Gheun-Ho Kim","doi":"10.5049/EBP.2011.9.2.55","DOIUrl":"https://doi.org/10.5049/EBP.2011.9.2.55","url":null,"abstract":"Proteinuria is a major promoter that induces tubulointerstitial injury in glomerulopathy. Dietary salt restriction may reduce proteinuria, although the mechanism is not clear. We investigated the effects of dietary salt restriction on rat kidneys in an animal model of glomerular proteinuria. Male Sprague-Dawley rats were used and divided into 3 groups: vehicle-treated normal-salt controls, puromycin aminonucleoside (PA)-treated normal-salt rats, and PA-treated low-salt rats. PA was given at a dose of 150 mg/kg BW at time 0, followed by 50 mg/kg BW on days 28, 35, and 42. Sodium-deficient rodent diet with and without additional NaCl (0.5%) were provided for normal-salt rats and low-salt rats, respectively. On day 63, kidneys were harvested for histopathologic examination and immunohistochemistry. PA treatment produced overt proteinuria and renal damage. Dietary salt restriction insignificantly reduced proteinuria in PA-treated rats, and PA-treated low-salt rats had lower urine output and lower creatinine clearance than vehicle-treated normal-salt controls. When tubulointerstitial injury was semiquantitatively evaluated, it had a positive correlation with proteinuria. The tubulointerstitial injury score was significantly increased by PA treatment and relieved by low-salt diet. ED1-positive infiltrating cells and immunostaining for interstitial collagen III were significantly increased by PA treatment. These changes appeared to be less common in PA-treated low-salt rats, although the differences in PA-treated normal-salt versus low-salt rats did not reach statistical significance. Our results suggest that renal histopathology in PA nephrosis may potentially be improved by dietary salt restriction. Non-hemodynamic mechanisms induced by low-sodium diet might contribute to renoprotection.","PeriodicalId":35352,"journal":{"name":"Electrolyte and Blood Pressure","volume":"9 2","pages":"55-62"},"PeriodicalIF":0.0,"publicationDate":"2011-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5049/EBP.2011.9.2.55","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30521686","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}
{"title":"Alkali therapy in patients with metabolic acidosis.","authors":"Viktor Rosival","doi":"10.5049/EBP.2011.9.1.38","DOIUrl":"https://doi.org/10.5049/EBP.2011.9.1.38","url":null,"abstract":"To the Editor: In his review \"Acid-Base Disorders in lCU Patients, Oh1) writes in the summary on p 66 \"The treatment target ... is not the acidosis, but the underlying condition causing acidosis\". In contrast to this statement, Edge et al.2) have concluded that the immediate cause of coma in patients with acidosis is the very low blood pH. The glycolytic enzyme phosphofructokinase is pH dependent, as its activity is decreasing with decreasing pH, and, thus, glucose utilization in brain cells is impaired3). For the readers of \"Electrolyte Blood Press\" it would be perhaps interesting to know, why the author did not comment the paper of Edge et al.2). \u0000 \u0000On p 69, the author writes \"HCO3- therapy does not improve the outcome in diabetic ketoacidosis ...\" Life-threatening is the most severe stage of diabetic ketoacidosis, coma. If the treatment of diabetic ketoacidotic coma included also infusions of alkalizing solutions, lethality was zero %, e g4). Without alkalizing solutions, lethality was up to 100%, e g5). Again, it would be perhaps interesting to know why the author did not comment the papers of Wagner et al.4) and Basu et al.5).","PeriodicalId":35352,"journal":{"name":"Electrolyte and Blood Pressure","volume":"9 1","pages":"38"},"PeriodicalIF":0.0,"publicationDate":"2011-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5049/EBP.2011.9.1.38","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30635494","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}
{"title":"The authors reply: alkali therapy in patients with metabolic acidosis.","authors":"Yun Kyu Oh","doi":"10.5049/EBP.2011.9.1.39","DOIUrl":"https://doi.org/10.5049/EBP.2011.9.1.39","url":null,"abstract":"The Authors Reply: Severe metabolic acidosis can generate detremental clinical effect such as cardiovascular depression and central nervous system dysfunction1). It also disturbe important key enzymes' activity2). The effect of bocarbonate therapy aimed at correcting the pH, however, is controversial. Bicarbonate therapy produced CO2 and paradoxically lower the intracellular pH and cerebrospinal fluid pH3, 4). Bicarbonate infusion is associated with an increased blood lactate levels4). It might be also produce the volume expansion, hypernatremia and renbound alkalemia. The other buffer agents such as Carbicarb (Na2CO3 + NaHCO3) and THAM (Tris-hydroxymethyl aminomethane) are available, but these agents dose not imporving outcomes of metabolic acidosis4). \u0000 \u0000Therefore, recent articles and text books suggest that therapy is aimed at correction of the underlying disorder, volume depletion, and electrolyte imbalance4-6). On condition that severe acidosis (pH < 7.1) and the patient is deteriorating rapidly, bicarbonate therapy can be considered.","PeriodicalId":35352,"journal":{"name":"Electrolyte and Blood Pressure","volume":"9 1","pages":"38-9"},"PeriodicalIF":0.0,"publicationDate":"2011-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5049/EBP.2011.9.1.39","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30635495","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}
Chang Seong Kim, Joon Seok Choi, Eun Hui Bae, Soo Wan Kim
{"title":"Hyponatremia associated with bupropion.","authors":"Chang Seong Kim, Joon Seok Choi, Eun Hui Bae, Soo Wan Kim","doi":"10.5049/EBP.2011.9.1.23","DOIUrl":"https://doi.org/10.5049/EBP.2011.9.1.23","url":null,"abstract":"<p><p>Bupropion is widely used for the treatment of depressive disorder and smoking cessation. Hyponatremia, including a syndrome of inappropriate secretion of antidiuretic hormone (SIADH), is not rare complication of treatment with antipsychotic drugs. We report a 60-year-old man who experienced severe hyponatremia after a treatment with bupropion for depressive disorder for the first time in the Korea.</p>","PeriodicalId":35352,"journal":{"name":"Electrolyte and Blood Pressure","volume":"9 1","pages":"23-6"},"PeriodicalIF":0.0,"publicationDate":"2011-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5049/EBP.2011.9.1.23","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30206441","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}
Sua Kim, Chor Ho Jo, Joon-Sung Park, Ho Jae Han, Gheun-Ho Kim
{"title":"The role of proximal nephron in cyclophosphamide-induced water retention: preliminary data.","authors":"Sua Kim, Chor Ho Jo, Joon-Sung Park, Ho Jae Han, Gheun-Ho Kim","doi":"10.5049/EBP.2011.9.1.7","DOIUrl":"https://doi.org/10.5049/EBP.2011.9.1.7","url":null,"abstract":"<p><p>Cyclophosphamide is clinically useful in treating malignancy and rheumatologic disease, but has limitations in that it induces hyponatremia. The mechanisms by which cyclophosphamide induces water retention in the kidney have yet to be identified. This study was undertaken to test the hypothesis that cyclophosphamide may produce water retention via the proximal nephron, where aquaporin-1 (AQP1) and aquaporin-7 (AQP7) water channels participate in water absorption. To test this hypothesis, we gave a single dose of intraperitoneal cyclophosphamide to male Sprague-Dawley rats and treated rabbit proximal tubule cells (PTCs) with 4-hydroperoxycyclophosphamide (4-HC), an active metabolite of cyclophosphamide. In the short-term 3-day rat study, AQP1 protein expression was significantly increased in the whole kidney homogenates by cyclophosphamide administration at 48 (614 ± 194%, P < 0.005), and 96 (460 ± 46%, P < 0.05) mg/kg BW compared with vehicle-treated controls. Plasma sodium concentration was significantly decreased (143 ± 1 vs. 146 ± 1 mEq/L, P < 0.05) by cyclophosphamide 100 mg/kg BW in the long-term 6-day rat study. When primary cultured rabbit PTCs were treated with 4-HC for 24 hours, the protein expressions of AQP1 and AQP7 were increased in a dose-dependent manner. Quantitative polymerase chain reaction revealed no significant changes in the mRNA levels of AQP1 and AQP7 from cyclophosphamide-treated rat renal cortices. From these preliminary data, we conclude that the proximal nephron may be involved in cyclophosphamide-induced water retention via AQP1 and AQP7 water channels. Further studies are required to demonstrate intracellular mechanisms that affect the expression of AQP proteins.</p>","PeriodicalId":35352,"journal":{"name":"Electrolyte and Blood Pressure","volume":"9 1","pages":"7-15"},"PeriodicalIF":0.0,"publicationDate":"2011-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5049/EBP.2011.9.1.7","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30206439","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}
Sang Won Park, Jeong Yup Kim, Gang Ji Go, Eun Sil Jeon, Heui Jung Pyo, Young Joo Kwon
{"title":"Orthorexia nervosa with hyponatremia, subcutaneous emphysema, pneumomediastimum, pneumothorax, and pancytopenia.","authors":"Sang Won Park, Jeong Yup Kim, Gang Ji Go, Eun Sil Jeon, Heui Jung Pyo, Young Joo Kwon","doi":"10.5049/EBP.2011.9.1.32","DOIUrl":"https://doi.org/10.5049/EBP.2011.9.1.32","url":null,"abstract":"<p><p>30-year-old male was admitted with general weakness and drowsy mental status. He had eaten only 3-4 spoons of brown rice and fresh vegetable without salt for 3 months to treat his tic disorder, and he had been in bed-ridden state. He has had weight loss of 14 kg in the last 3 months. We report a patient with orthorexia nervosa who developed hyponatremia, metabolic acidosis, subcutaneous emphysema, mediastinal emphysema, pneumothorax, and pancytopenia and we will review the literature. Also, we mention to prevent refeeding syndrome, and to start and maintain feeding in malnourished patients.</p>","PeriodicalId":35352,"journal":{"name":"Electrolyte and Blood Pressure","volume":"9 1","pages":"32-7"},"PeriodicalIF":0.0,"publicationDate":"2011-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5049/EBP.2011.9.1.32","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30206443","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}
{"title":"Vitamin d, and kidney disease.","authors":"Hyung Soo Kim, Wookyung Chung, Sejoong Kim","doi":"10.5049/EBP.2011.9.1.1","DOIUrl":"https://doi.org/10.5049/EBP.2011.9.1.1","url":null,"abstract":"<p><p>Mineral metabolism abnormalities, such as low 1,25-dihydroxyvitamin D (1,25(OH)(2)D) and elevated parathyroid hormone (PTH), are common at even higher glomerular filtration rate than previously described. Levels of 25-hydroxyvitamin D (25(OH)D) show an inverse correlation with those of intact PTH and phosphorus. Studies of the general population found much higher all-cause and cardiovascular (CV) mortality for patients with lower levels of vitamin D; this finding suggests that low 25(OH)D level is a risk factor and predictive of CV events in patients without chronic kidney disease (CKD). 25(OH)D/1,25(OH)2D becomes deficient with progression of CKD. Additionally, studies of dialysis patients have found an association of vitamin D deficiency with increased mortality. Restoration of the physiology of vitamin D receptor activation should be essential therapy for CKD patients.</p>","PeriodicalId":35352,"journal":{"name":"Electrolyte and Blood Pressure","volume":"9 1","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2011-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5049/EBP.2011.9.1.1","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30208647","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}
{"title":"Is There a Relationship between Hyperkalemia and Propofol?","authors":"Ju-Hyun Lee, Young-Sun Ko, Hyun-Jong Shin, Joo-Hark Yi, Sang-Woong Han, Ho-Jung Kim","doi":"10.5049/EBP.2011.9.1.27","DOIUrl":"https://doi.org/10.5049/EBP.2011.9.1.27","url":null,"abstract":"<p><p>This is a case of a sudden cardio-pulmonary arrest in a 29 year-old female, which occurred immediately after a large bolus infusion of propofol (100 mg) intravenously during dilatation and curettage. The arrest suddenly occurred, and the patient was eventually transferred to our emergency room (ER) on cardiopulmonary resuscitation. At that time, severe hyperkalemia up to 9.1 mEq/L and ventricular fibrillation were noted. Resuscitation in ER worked successfully with conversion of electrocardiograph to sinus rhythm, but this patient expired unfortunately. On view of this acute event immediately after the bolus injection of propofol accompanied without other identified causes, severe hyperkalemia induced by propofol was strongly assumed to be the cause of death. To our understanding with the literature survey, propofol as a cause of hyperkalemia has not been well described yet. Through this case, the relationship as a cause and an effect between propofol and hyperkalemia is suggested.</p>","PeriodicalId":35352,"journal":{"name":"Electrolyte and Blood Pressure","volume":"9 1","pages":"27-31"},"PeriodicalIF":0.0,"publicationDate":"2011-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5049/EBP.2011.9.1.27","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30206442","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}
{"title":"Recent Advances of Oral Rehydration Therapy (ORT).","authors":"Jin-Soon Suh, Won-Ho Hahn, Byoung-Soo Cho","doi":"10.5049/EBP.2010.8.2.82","DOIUrl":"https://doi.org/10.5049/EBP.2010.8.2.82","url":null,"abstract":"<p><p>Diarrheal disease is one of the leading causes of worldwide morbidity and mortality, especially in children. It causes loss of body fluid, which may lead to severe dehydration, electrolyte imbalance, shock and even to death. The mortality rate from acute diarrhea has decreased over the last few decades. This decline, especially in developing countries is largely due to the implantation of the standard World Health Organization-oral rehydration solution (WHO-ORS). However, the use of standard ORS has been limited by its inability to reduce fecal volume or diarrhea duration. Subsequently, this has led to various attempts to modify its compositions. And these modifications include the use of reduced osmolarity ORS, polymer-based ORS and zinc supplementation. Some of these variations have been successful and others are still under investigation. Therefore, further trials are needed to progress toward the ideal ORS. In this article, we briefly reviewed the pathophysiologic basis of the ORS, followed by the standard WHO-ORS and several modifications to improve the ORS.</p>","PeriodicalId":35352,"journal":{"name":"Electrolyte and Blood Pressure","volume":"8 2","pages":"82-6"},"PeriodicalIF":0.0,"publicationDate":"2010-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5049/EBP.2010.8.2.82","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29795082","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}