Electrolyte and Blood Pressure最新文献_第2页

Integrating Blood Pressure Control With Multi-Class Kidney Protective Agents in Diabetic Kidney Disease. 结合多种肾保护药物控制血压治疗糖尿病肾病。

Electrolyte and Blood Pressure Pub Date : 2026-06-01 Epub Date: 2026-06-02 DOI: 10.5049/EBP.2026.24.e6

Hyoungnae Kim

{"title":"Integrating Blood Pressure Control With Multi-Class Kidney Protective Agents in Diabetic Kidney Disease.","authors":"Hyoungnae Kim","doi":"10.5049/EBP.2026.24.e6","DOIUrl":"10.5049/EBP.2026.24.e6","url":null,"abstract":"Diabetic kidney disease (DKD) remains a leading cause of chronic kidney disease progression and cardiovascular morbidity and mortality. Blood pressure (BP) control is a cornerstone of risk reduction in DKD, yet its management has become increasingly complex with the emergence of multi-class kidney-protective agents. Traditionally centered on renin-angiotensin-aldosterone system (RAAS) blockade with additional antihypertensive agents, contemporary treatment now incorporates sodium-glucose cotransporter-2 (SGLT2) inhibitors, non-steroidal mineralocorticoid receptor antagonists, and incretin-based therapies. Recent trials evaluating intensive systolic BP targets have demonstrated cardiovascular benefit in selected high-risk populations; however, the balance between benefit and kidney-related harm remains relevant in DKD. While RAAS blockade provides meaningful BP reduction and renoprotection, SGLT2 inhibitors, finerenone, and incretin-based therapies confer modest but clinically relevant BP lowering alongside substantial cardiorenal benefits through complementary mechanisms. Although these agents are not primarily used for antihypertensive intensification, their meaningful BP-lowering effects can influence overall BP control in routine practice. Although combination therapy appears biologically plausible and may enhance overall cardio-kidney-metabolic protection, definitive evidence supporting optimal sequencing, parallel initiation, or superiority in hard clinical outcomes remains limited. A pragmatic, individualized approach integrating disease-modifying therapies with conventional antihypertensive agents is therefore warranted. Future dedicated trials are needed to clarify optimal integration strategies to achieve safe BP control while maximizing long-term kidney and cardiovascular protection in DKD.","PeriodicalId":35352,"journal":{"name":"Electrolyte and Blood Pressure","volume":"24 2","pages":"95-105"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13338641/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148406151","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

Patient and Clinician Perspectives on Hyperkalemia Management Under Cardio-Kidney-Protective Therapy: A Three-Stakeholder Cross-Sectional Survey. 心肾保护治疗下高钾血症管理的患者和临床观点：一项三利益相关者横断面调查。

Electrolyte and Blood Pressure Pub Date : 2026-06-01 Epub Date: 2026-06-29 DOI: 10.5049/EBP.2026.24.e9

Yongjin Yi, Seon Ha Baek, Jeonghwan Lee, Sejoong Kim

{"title":"Patient and Clinician Perspectives on Hyperkalemia Management Under Cardio-Kidney-Protective Therapy: A Three-Stakeholder Cross-Sectional Survey.","authors":"Yongjin Yi, Seon Ha Baek, Jeonghwan Lee, Sejoong Kim","doi":"10.5049/EBP.2026.24.e9","DOIUrl":"10.5049/EBP.2026.24.e9","url":null,"abstract":"Background: Maintaining renin-angiotensin system inhibitor (RASi) and mineralocorticoid receptor antagonist (MRA) therapy in patients with hyperkalemia is now favored by contemporary guidelines, yet the perspectives of patients and clinicians on this shift have rarely been examined in parallel.Methods: We conducted three parallel descriptive cross-sectional surveys in Korea between April and May 2026: a patient survey distributed through a kidney-disease patient community; a nephrologist survey; and a multispecialty physician survey. Patients, nephrology specialists, and multispecialty physicians were analyzed separately and in a combined nephrologist-versus-non-nephrologist comparison.Results: A total of 125 patients, 82 nephrologists, and 255 multispecialty physicians completed the survey. Patient awareness of hyperkalemia was high (perceived risk, 3.97; 95% confidence interval, 3.84-4.10). More patients preferred potassium-lowering medication (68.8%) over strict dietary control (31.2%) for hyperkalemia management. Clinicians rated maintenance of RASi and MRA as 3.81 (3.72-3.90) and 3.47 (3.37-3.56), respectively; nephrologists rated maintenance as more important than non-nephrologists for both classes (p < 0.001 for RASi, p = 0.006 for MRA). For long-term outpatient hyperkalemia, nephrologists most often endorsed prescribing a potassium binder (68.2%), while non-nephrologists most often endorsed reducing or discontinuing the culprit drugs (55.5%).Conclusion: Patients preferred to maintain cardio-kidney-protective therapy. A specialty gap in this preference was observed between nephrologists and non-nephrology clinicians, indicating a need to broaden clinician awareness of the full spectrum of hyperkalemia management options, including the more active use of potassium-lowering agents.","PeriodicalId":35352,"journal":{"name":"Electrolyte and Blood Pressure","volume":"24 2","pages":"129-145"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13338643/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148406099","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

Advances in Hyperkalemia Management and the Emerging Role of Sodium Zirconium Cyclosilicate. 高钾血症的治疗进展及环硅酸锆钠的新作用。

Electrolyte and Blood Pressure Pub Date : 2026-03-01 Epub Date: 2026-03-26 DOI: 10.5049/EBP.2026.24.e3

Jinah Jung, Sonia Juarez, Eun Sil Koh, Sungjin Chung

引用次数: 0

The Proposed Chronic Kidney Disease Management Act in Korea: A Step Toward a National Strategy for Kidney Disease Prevention and Care. 韩国慢性肾脏疾病管理法提案：迈向肾脏疾病预防和护理国家战略的一步。

Electrolyte and Blood Pressure Pub Date : 2026-03-01 Epub Date: 2026-03-24 DOI: 10.5049/EBP.2026.24.e2

Sungjin Chung, Hyung Eun Son, Jung Pyo Lee, Hyeong Cheon Park

引用次数: 0

Korean Society of Nephrology 2025 Evidence-Based Clinical Practice Guideline for Continuous Kidney Replacement Therapy. 韩国肾脏学会2025循证临床实践指南持续肾脏替代治疗。

Electrolyte and Blood Pressure Pub Date : 2026-03-01 Epub Date: 2026-03-09 DOI: 10.5049/EBP.2026.24.e1

Jeonghwan Lee, Donghyuk Kang, Jin Hyuk Paek, Jangwook Lee, Jung Nam An, Junseok Jeon, Kyungho Lee, Hye Ryoun Jang, Jong Hyun Jhee, Hyo Jin Kim, Harin Rhee, Sung Yoon Lim, Jihyun Yang, Seong Geun Kim, Seung Seok Han, Shin Young Ahn, Sunghoon Park, Hyun Kyung Lee, Heeyeon Cho, Yeonhee Lee, Hyung Woo Kim, Keonhwa Kim, Miyoung Choi, Sejoong Kim

{"title":"Korean Society of Nephrology 2025 Evidence-Based Clinical Practice Guideline for Continuous Kidney Replacement Therapy.","authors":"Jeonghwan Lee, Donghyuk Kang, Jin Hyuk Paek, Jangwook Lee, Jung Nam An, Junseok Jeon, Kyungho Lee, Hye Ryoun Jang, Jong Hyun Jhee, Hyo Jin Kim, Harin Rhee, Sung Yoon Lim, Jihyun Yang, Seong Geun Kim, Seung Seok Han, Shin Young Ahn, Sunghoon Park, Hyun Kyung Lee, Heeyeon Cho, Yeonhee Lee, Hyung Woo Kim, Keonhwa Kim, Miyoung Choi, Sejoong Kim","doi":"10.5049/EBP.2026.24.e1","DOIUrl":"10.5049/EBP.2026.24.e1","url":null,"abstract":"The Korean Society of Critical Care Nephrology, in collaboration with the Korean Society of Nephrology, has published a clinical practice guideline for continuous kidney replacement therapy (CKRT). This guideline was developed with the goal of improving patient outcomes and reducing complications, based on the latest research related to the application and prescription of CKRT. The development of this guideline involved multidisciplinary participation from leading experts in nephrology and critical care medicine, with methodological support for the guideline development process. This clinical practice guideline consists of recommendations addressing 17 key questions related to the initiation of CKRT, dose, modality, dialysate, ultrafiltration, anticoagulation, application in special situations, and multidisciplinary care. Each recommendation begins with a statement graded by the strength of the recommendation and the quality of the supporting evidence, followed by a rationale that supports the recommendation. We hope that this clinical practice guideline will offer practical guidance in clinical settings and contribute to the improvement of patient outcomes.","PeriodicalId":35352,"journal":{"name":"Electrolyte and Blood Pressure","volume":"24 1","pages":"6-72"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13054007/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147639775","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

Mechanism of Sodium-Glucose Cotransporter-2 Inhibitors for Uricosuria. 钠-葡萄糖共转运蛋白-2抑制剂治疗尿路的机制。

Electrolyte and Blood Pressure Pub Date : 2025-12-01 Epub Date: 2025-12-29 DOI: 10.5049/EBP.2025.23.e5

Eunjin Bae

{"title":"Mechanism of Sodium-Glucose Cotransporter-2 Inhibitors for Uricosuria.","authors":"Eunjin Bae","doi":"10.5049/EBP.2025.23.e5","DOIUrl":"10.5049/EBP.2025.23.e5","url":null,"abstract":"Clinical trials have found that sodium-glucose cotransporter-2 (SGLT2) inhibitors reduce serum urate levels by 0.6-1.5 mg/dL, which might contribute to cardiovascular protection. Urate is the final degradation product of purine nucleotides in humans who lack uricase, unlike most mammals. Thus, the processes of urate handling differ. This review aims to address the handling of urate in humans and the mechanisms through which SGLT2 inhibitors reduce serum urate levels. The kidneys and intestines are respectively responsible for excreting 70% and 30% of urate in humans. Medications that inhibit urate excretion, as well as increased purine intake or production, can cause hyperuricemia and decrease kidney function, which plays a key role in urate excretion. Hyperuricemia is significantly associated with gout, renal stones, mortality, and cardiovascular and chronic kidney diseases. SGLT2 inhibitors lower serum urate by inhibiting its reabsorption through urate anion exchanger 1 in apical membranes of renal proximal tubules and promoting urate excretion through ATP-binding cassette subfamily G member 2 (ABCG2) located in the apical membrane of the proximal tubule and ABCG2 in the intestinal membrane. Further mechanistic studies are needed to elucidate how SGLT2 inhibitors lower serum urate levels. Although the clinical benefits of SGLT2 inhibitors probably do not arise solely from urate reduction, they decrease serum urate levels, suggesting that they could serve as adjunctive therapy for patients with hyperuricemia.","PeriodicalId":35352,"journal":{"name":"Electrolyte and Blood Pressure","volume":"23 2","pages":"23-30"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12802067/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145990418","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

Unusual Presentation of Hyponatremia: Persistent Hiccups. 低钠血症的不寻常表现：持续打嗝。

Electrolyte and Blood Pressure Pub Date : 2025-12-01 Epub Date: 2025-12-31 DOI: 10.5049/EBP.2025.23.e6

Sunmin Lee, Hee Won Seo, Jiwon Lee, Mi-Yeon Yu, Sang-Woong Han

引用次数: 0

Relationship Between Cardiac Autonomic Control and Intradialytic Hypotension in Senegalese Chronic Hemodialysis Patients: A Single Center Prospective Study. 塞内加尔慢性血液透析患者心脏自主控制与透析内低血压的关系：一项单中心前瞻性研究。

Electrolyte and Blood Pressure Pub Date : 2025-12-01 Epub Date: 2025-12-29 DOI: 10.5049/EBP.2025.23.e4

Ibrahima Lyra Sarr, Abdou Khadir Sow, Baratou Coundoul, Babacar Mbodj, Sidy Mohamed Seck

{"title":"Relationship Between Cardiac Autonomic Control and Intradialytic Hypotension in Senegalese Chronic Hemodialysis Patients: A Single Center Prospective Study.","authors":"Ibrahima Lyra Sarr, Abdou Khadir Sow, Baratou Coundoul, Babacar Mbodj, Sidy Mohamed Seck","doi":"10.5049/EBP.2025.23.e4","DOIUrl":"10.5049/EBP.2025.23.e4","url":null,"abstract":"Background: Intradialytic hypotension (IDH) increases cardiovascular morbidity and mortality in chronic hemodialysis patients and cardiac autonomous neuropathy (CAN) might be involved. To assess cardiac autonomic control in hemodialysis patients and describe its relationship with IDH.Methods: We conducted a prospective study at Ouakam Military Hospital in Senegal from January 1st to March 31st, 2023. Fifty-two patients (31 men, mean age 47.54 years) were included and had 3 measurements of heart rate variability (HRV): before, during and after an index hemodialysis session. They were classified according to changes in systolic blood pressure (SBP) during hemodialysis into three groups: 14 patients in group I (increase > 10 mmHg in mean intradialytic SBP), 13 in group II (decrease ≥ 20 mmHg in mean intradialytic SBP or MAP > 10 mmHg) and 25 in group III (others). HRV frequency domain indices between groups were compared.Results: In pre-dialysis, patients in group II showed higher values in total power (650.30 vs. 94.94 and 108.11 ms2, p = 0.02), high frequency (199.24 vs. 25.05 and 25.90 ms2, p = 0.03) and low frequency (225.36 vs. 42.30 and 53.76 ms2, p = 0.01) compared to those in groups I and III. Also, they presented less severe CAN (16.2% vs. 57.2% and 56%, p = 0.03). Measures after dialysis found no difference in HRV parameters among the three groups.Conclusion: Our results found that HRV was similar between patients with and without IDH suggesting the influence of other risk factors that need to be explored in further studies.","PeriodicalId":35352,"journal":{"name":"Electrolyte and Blood Pressure","volume":"23 2","pages":"31-42"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12802086/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145991014","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

A Case of Cystinuria With Compound Heterozygous Mutations Both in SLC3A1 and SLC7A9 Genes. SLC3A1和SLC7A9基因复合杂合突变的胱氨酸尿症1例。

Electrolyte and Blood Pressure Pub Date : 2025-06-01 Epub Date: 2025-06-23 DOI: 10.5049/EBP.2025.23.e2

Sang Heon Suh, Su Hyun Song, Hong Sang Choi, Chang Seong Kim, Eun Hui Bae, Soo Wan Kim, Seong Kwon Ma

{"title":"A Case of Cystinuria With Compound Heterozygous Mutations Both in SLC3A1 and SLC7A9 Genes.","authors":"Sang Heon Suh, Su Hyun Song, Hong Sang Choi, Chang Seong Kim, Eun Hui Bae, Soo Wan Kim, Seong Kwon Ma","doi":"10.5049/EBP.2025.23.e2","DOIUrl":"10.5049/EBP.2025.23.e2","url":null,"abstract":"Cystinuria is an autosomal recessively inherited genetic disorder, and is typically classified into type A, caused by mutations in SLC3A1, or type B, caused by mutations in SLC7A9. While the predominance of the genotypes varies among countries, due to lack of a large scale cohort, the characterization of mutations in SLC3A1 or SLC7A9 is still limited in East Asia. A 61-year-old male patient admitted to the department of nephrology, with a chief complaint of fever, chillness and left flank pain for a week. The patient had a past history of recurrent urolithiasis, with a frequency of at least 1 to 2 times a year. Computed tomography visualized 1 cm-sized stone at distal ureter, which was removed by retrograde ureteroscopy. The stone analysis documented 100% of cystine, indicating an underlying genetic disorder, cystinuria. Whole genome sequencing from peripheral blood unveiled 3 heterozygous missense mutations in coding exons of SLC3A1 gene, and 2 heterozygous missense mutations in coding exons of SLC7A9 gene. We here report a case of cystinuria with compound heterozygous mutations both in SLC3A1 and SLC7A9 genes, with a total of 5 mutant alleles in a patient.","PeriodicalId":35352,"journal":{"name":"Electrolyte and Blood Pressure","volume":"23 1","pages":"17-21"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12230274/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144592483","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

Renal Safety of Telminuvo, a Single Pill Combination of Telmisartan and S-amlodipine, in Korean Hypertensive Patients: A Multicenter, Retrospective Cohort Study. 替米沙坦和s -氨氯地平联合用药Telminuvo在韩国高血压患者中的肾脏安全性：一项多中心、回顾性队列研究。

Electrolyte and Blood Pressure Pub Date : 2025-06-01 Epub Date: 2025-05-08 DOI: 10.5049/EBP.2025.23.e1

Hongran Moon, Sohyun Bae, Donghwan Yun, Hyung-Kwan Kim, Sung Uk Kwon, Min Su Hyon, Seung Seok Han

{"title":"Renal Safety of Telminuvo, a Single Pill Combination of Telmisartan and S-amlodipine, in Korean Hypertensive Patients: A Multicenter, Retrospective Cohort Study.","authors":"Hongran Moon, Sohyun Bae, Donghwan Yun, Hyung-Kwan Kim, Sung Uk Kwon, Min Su Hyon, Seung Seok Han","doi":"10.5049/EBP.2025.23.e1","DOIUrl":"10.5049/EBP.2025.23.e1","url":null,"abstract":"Background: Effective blood pressure (BP) control is vital for preventing target organ damage, and combination therapy offers added benefits when single-agent treatment is insufficient. This cohort study examined whether Telminuvo, a single-pill combination of telmisartan and S-amlodipine, effectively maintains kidney function as a target organ in a large cohort of Korean patients.Methods: A total of 4,934 patients from 30 hospitals were treated with Telminuvo for over six months, with BP, estimated glomerular filtration rate (eGFR), electrolyte levels, and adverse events monitored throughout the study period.Results: Among the participants, 1,463 (29.7%) used Telminuvo for less than 1 year, while the remainder used it for longer. At baseline, the systolic and diastolic BP averaged 140.2 ± 18.4 mmHg and 82.1 ± 13.4 mmHg, respectively, which significantly decreased to approximately 130 and 75 mmHg after the initiation of treatment. The baseline eGFR of 79.3 mL/min/1.73 m2 remained stable over three years, regardless of the initial eGFR levels. Within the first six months, acute kidney injury (defined as either a ≥ 0.3 mg/dL increase in serum creatinine or a ≥ 50% increase from baseline) occurred in 6.6% of patients, while hyperkalemia (defined as serum potassium levels > 5.5 mmol/L) was observed in 3.2% of patients.Conclusion: This cohort study demonstrates that Telminuvo effectively reduces blood pressure without compromising kidney function. Furthermore, the findings provide additional insights into drug-related adverse events, which will be valuable for clinicians in the real-world prescribing of Telminuvo.","PeriodicalId":35352,"journal":{"name":"Electrolyte and Blood Pressure","volume":"23 1","pages":"1-10"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12230273/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144592485","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