Electrolyte and Blood Pressure最新文献

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Post-Hypercapnic Alkalosis: A Brief Review. 后高碳酸碱中毒:简要回顾。
Electrolyte and Blood Pressure Pub Date : 2023-06-01 DOI: 10.5049/EBP.2023.21.1.18
Yongjin Yi
{"title":"Post-Hypercapnic Alkalosis: A Brief Review.","authors":"Yongjin Yi","doi":"10.5049/EBP.2023.21.1.18","DOIUrl":"https://doi.org/10.5049/EBP.2023.21.1.18","url":null,"abstract":"<p><p>Metabolic alkalosis is a common acid-base imbalance frequently observed in intensive care unit (ICU) patients and is associated with increased mortality. Post-hypercarbia alkalosis (PHA) is a type of metabolic alkalosis caused by sustained high serum bicarbonate levels following a rapid resolution of hypoventilation in patients with chronic hypercapnia due to prolonged respiratory disturbance. Common causes of chronic hypercapnia include chronic obstructive pulmonary disease (COPD), central nervous system disorders, neuromuscular disorders, and narcotic abuse. Rapid correction of hypercapnia through hyperventilation leads to a swift normalization of pCO<sub>2</sub>, which lacks renal compensation, consequently causing an increase in plasma HCO<sub>3-</sub> levels and severe metabolic alkalosis. Most of PHA occurs in the ICU setting requiring mechanical ventilation and can progress severe alkalemia due to secondary mineralocorticoid excess from volume depletion or decreased HCO<sub>3-</sub> excretion from decreased glomerular filtration rate and increased proximal tubular reabsorption. PHA is associated with increased ICU stay, ventilator dependency, and mortality. Acetazolamide, a carbonic anhydrase inhibitor, has been utilized for managing PHA by inducing alkaline diuresis and reducing tubular reabsorption of bicarbonate. While acetazolamide effectively improves alkalemia, its impact on hard outcomes may be limited by factors such as patient complexity, co-administered medications, and underlying conditions contributing to alkalosis.</p>","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/89/1b/ebp-21-18.PMC10329906.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10172012","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 Replacement Therapy For Elderly Patients with ESKD Through Shared Decision-Making. 通过共同决策对老年ESKD患者进行肾脏替代治疗。
Electrolyte and Blood Pressure Pub Date : 2023-06-01 DOI: 10.5049/EBP.2023.21.1.1
Jin Eop Kim, Woo Yeong Park, Hyunsuk Kim
{"title":"Renal Replacement Therapy For Elderly Patients with ESKD Through Shared Decision-Making.","authors":"Jin Eop Kim,&nbsp;Woo Yeong Park,&nbsp;Hyunsuk Kim","doi":"10.5049/EBP.2023.21.1.1","DOIUrl":"https://doi.org/10.5049/EBP.2023.21.1.1","url":null,"abstract":"<p><p>The incidence and prevalence of end-stage kidney disease (ESKD) in Korea are increasing, and ESKD constitutes a very important medical and social issue. Elderly dialysis patients have the highest risk of early mortality within 3 months after initiating dialysis, and geriatric syndromes such as aging, frailty, functional impairment, and cognitive impairment are crucial for the prognosis of elderly patients. Shared decision-making (SDM) is an approach through which clinicians and patients can achieve informed preferences, thereby yielding better clinical outcomes and quality of life. Through SDM-based, close consultation among patients, families, and healthcare providers, an ESKD Life-Plan for elderly patients should be established. A multidisciplinary approach led by nephrologists can help them to provide proper vascular access for dialysis at the right time, with the right evidence, and to the right patient. Strategies that can improve peritoneal dialysis in elderly patients include assisted peritoneal dialysis, homecare support programs, and automated peritoneal dialysis. In order to enhance the role of kidney transplantation in elderly patients with ESKD, it is necessary to accurately identify patients' clinical conditions before transplantation and to perform active rehabilitation activities and postoperative management to promote recovery after transplantation. With the aging population and the increase in ESKD in the elderly, clinicians must identify factors affecting the mortality and quality of life of elderly dialysis patients.</p>","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/e4/45/ebp-21-1.PMC10329902.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10191206","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
Management of Hypertension in Fabry Disease. 法布里病高血压的治疗。
Electrolyte and Blood Pressure Pub Date : 2023-06-01 DOI: 10.5049/EBP.2023.21.1.8
Su Hyun Kim, Soo Jeong Choi
{"title":"Management of Hypertension in Fabry Disease.","authors":"Su Hyun Kim,&nbsp;Soo Jeong Choi","doi":"10.5049/EBP.2023.21.1.8","DOIUrl":"https://doi.org/10.5049/EBP.2023.21.1.8","url":null,"abstract":"<p><p>Fabry disease (FD), a rare X-linked lysosomal storage disorder that depletes alpha-galactosidase A (α-GalA), is caused by mutations in the GLA gene. Diminished α-GalA enzyme activity results in the accumulation of Gb3 and lyso-Gb3. The pathophysiology of hypertension in FD is complex and unclear. The storage of Gb3 in arterial endothelial cells and smooth muscle cells is known to produce vascular injury by increasing oxidative stress and inflammatory cytokines as a primary pathophysiological mechanism. In addition, Fabry nephropathy developed, resulting in a decrease in kidney function and contributing to hypertension. The prevalence of hypertension in patients with FD was between 28.4% and 56%, whereas hypertension in patients with chronic kidney disease ranged between 33% and 79%. A study using 24-hour ambulatory blood pressure monitoring (ABPM) to measure blood pressure (BP) indicated a high prevalence of uncontrolled hypertension in FD. Thus, 24-hour ABPM ought to be considered for FD hypertension assessments. Appropriate treatment of hypertension is believed to reduce mortality in patients with FD caused by kidney disease, cardiovascular disease, and cerebrovascular disease because hypertension significantly impacts organ damage. Up to 70% of FD patients have been reported to have kidney involvement, and angiotensin-converting enzyme inhibitors and angiotensin receptor blockers prescribed for proteinuria are recommended as first-line therapy with antihypertensive drugs. In conclusion, hypertension should be controlled appropriately, given the different morbidity and mortality caused by significant organ involvement in FD patients.</p>","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/3b/5a/ebp-21-8.PMC10329903.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9869891","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
Understanding and Treatment Strategies of Hypertension and Hyperkalemia in Chronic Kidney Disease. 慢性肾脏疾病高血压和高钾血症的认识及治疗策略。
Electrolyte and Blood Pressure Pub Date : 2023-06-01 DOI: 10.5049/EBP.2023.21.1.24
Sang Min Jo
{"title":"Understanding and Treatment Strategies of Hypertension and Hyperkalemia in Chronic Kidney Disease.","authors":"Sang Min Jo","doi":"10.5049/EBP.2023.21.1.24","DOIUrl":"https://doi.org/10.5049/EBP.2023.21.1.24","url":null,"abstract":"<p><p>Hypertension and potassium imbalance are commonly observed in chronic kidney disease (CKD) patients. The development of hypertension would be related to several mechanisms. Hypertension is related to body mass index, dietary salt intake, and volume overload and is treated with antihypertensives. In CKD patients, managing hypertension can provide important effects that can slow the progression of CKD or reduce complications associated with reduced glomerular filtration rate. The prevalence of hyperkalemia and hypokalemia in CKD patients was similar at 15-20% and 15-18%, respectively, but more attention needs to be paid to treating and preventing hyperkalemia, which is related to a higher mortality rate, than hypokalemia. Hyperkalemia is prevalent in CKD due to impaired potassium excretion. Serum potassium level is affected by renin-angiotensin-aldosterone system inhibitors and diuretics and dietary potassium intake and can be managed by potassium restriction dietary, optimized renin-angiotensin-aldosterone system inhibitor, sodium polystyrene sulfonate, patiromer, and hemodialysis. This review discussed strategies to mitigate and care for the risk of hypertension and hyperkalemia in CKD patients.</p>","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/0b/03/ebp-21-24.PMC10329905.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9869894","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
Blood Pressure Control in Elderly Chronic Kidney Disease Patients. 老年慢性肾病患者的血压控制。
Electrolyte and Blood Pressure Pub Date : 2022-12-01 DOI: 10.5049/EBP.2022.20.2.57
Jae Won Yang
{"title":"Blood Pressure Control in Elderly Chronic Kidney Disease Patients.","authors":"Jae Won Yang","doi":"10.5049/EBP.2022.20.2.57","DOIUrl":"https://doi.org/10.5049/EBP.2022.20.2.57","url":null,"abstract":"<p><p>In elderly chronic kidney disease (CKD) patients, isolated systolic hypertension is common, the rate of renal function decline is slow, and there is a high possibility of physical damage due to side effects such as drug use-related orthostatic hypotension. Therefore, there are still many questions about whether lowering blood pressure in elderly patients will actually improve prognosis. Since many blood pressure-related clinical studies exclude advanced CKD and the elderly, it is particularly difficult to define target blood pressure in these populations. A randomized controlled trial is needed to establish optimal blood pressure targets and treatment strategies in elderly patients with CKD. This review seeks to summarize the guidelines available at this time.</p>","PeriodicalId":35352,"journal":{"name":"Electrolyte and Blood Pressure","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/39/4e/ebp-20-57.PMC9827045.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9176492","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
Bartter Syndrome: Perspectives of a Pediatric Nephrologist. 巴特综合征:儿科肾病专家的观点。
Electrolyte and Blood Pressure Pub Date : 2022-12-01 DOI: 10.5049/EBP.2022.20.2.49
Naye Choi, Hee Gyung Kang
{"title":"Bartter Syndrome: Perspectives of a Pediatric Nephrologist.","authors":"Naye Choi,&nbsp;Hee Gyung Kang","doi":"10.5049/EBP.2022.20.2.49","DOIUrl":"https://doi.org/10.5049/EBP.2022.20.2.49","url":null,"abstract":"Bartter syndrome (BS) is one of the most well-known hereditary tubular disorders, characterized by hypokalemic, hypochloremic metabolic alkalosis, and polyuria/polydipsia. This disease usually presents before or during infancy, and adult nephrologists often inherit the patients from pediatric nephrologists since this is a life-long condition. Here, a few case scenarios will be presented to recount how they first got diagnosed and how their clinical courses were during childhood until adulthood, in addition to a brief review of the disease and its treatment.","PeriodicalId":35352,"journal":{"name":"Electrolyte and Blood Pressure","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/66/8a/ebp-20-49.PMC9827044.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9176489","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
Management for Electrolytes Disturbances during Continuous Renal Replacement Therapy. 持续肾替代治疗期间电解质紊乱的处理。
Electrolyte and Blood Pressure Pub Date : 2022-12-01 DOI: 10.5049/EBP.2022.20.2.64
Song In Baeg, Kyungho Lee, Junseok Jeon, Hye Ryoun Jang
{"title":"Management for Electrolytes Disturbances during Continuous Renal Replacement Therapy.","authors":"Song In Baeg,&nbsp;Kyungho Lee,&nbsp;Junseok Jeon,&nbsp;Hye Ryoun Jang","doi":"10.5049/EBP.2022.20.2.64","DOIUrl":"https://doi.org/10.5049/EBP.2022.20.2.64","url":null,"abstract":"<p><p>Despite the lack of proven superiority in mortality compared to intermittent hemodialysis, continuous renal replacement therapy (CRRT) is the preferred renal replacement therapy modality for critically ill patients with acute kidney injury (AKI) due to better hemodynamic stability and steady correction of electrolytes disturbances and volume overload. Multiple and complex electrolyte disorders in patients with AKI can be managed effectively with CRRT because controlled and predictable correction is feasible. Thus, CRRT has an advantage with safety over conventional hemodialysis, especially in patients with both renal dysfunction and electrolyte disorder that require a sophisticated treatment with avoidance of rapid correction. On the contrary, CRRT can potentially lead to paradoxical disturbance of electrolytes such as hypokalemia or hypophosphatemia, especially in patients under high dose or prolonged duration of CRRT treatment. These electrolytes related complications can be prevented with close monitoring followed by the appropriate use of CRRT fluids. Although there is a lack of solid evidence and standardized guideline for CRRT prescriptions, optimal management of various electrolyte disturbances can be achieved with individualized and tailored dialysate and replacement fluid prescriptions. Several commercially available CRRT solutions with varying compositions provide flexibility to manage electrolyte disorders and maintain the stability of electrolyte. In this review, we discuss various prescription methods to manage common electrolyte imbalances as well as preventative strategies to maintain electrolyte homeostasis during CRRT providing detailed protocols used in our center. This review may contribute to future research that can lead to the development of clinical practice guidelines.</p>","PeriodicalId":35352,"journal":{"name":"Electrolyte and Blood Pressure","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c2/a8/ebp-20-64.PMC9827043.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10145971","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
Blood Pressure Control in Patients with Diabetic Kidney Disease. 糖尿病肾病患者的血压控制。
Electrolyte and Blood Pressure Pub Date : 2022-12-01 Epub Date: 2022-12-30 DOI: 10.5049/EBP.2022.20.2.39
Yaeni Kim, Won Kim, Jwa-Kyung Kim, Ju Young Moon, Samel Park, Cheol Whee Park, Hoon Suk Park, Sang Heon Song, Tae-Hyun Yoo, So-Young Lee, Eun Young Lee, Jeonghwan Lee, Kyubok Jin, Dae Ryong Cha, Jin Joo Cha, Sang Youb Han
{"title":"Blood Pressure Control in Patients with Diabetic Kidney Disease.","authors":"Yaeni Kim, Won Kim, Jwa-Kyung Kim, Ju Young Moon, Samel Park, Cheol Whee Park, Hoon Suk Park, Sang Heon Song, Tae-Hyun Yoo, So-Young Lee, Eun Young Lee, Jeonghwan Lee, Kyubok Jin, Dae Ryong Cha, Jin Joo Cha, Sang Youb Han","doi":"10.5049/EBP.2022.20.2.39","DOIUrl":"10.5049/EBP.2022.20.2.39","url":null,"abstract":"<p><p>Diabetic kidney disease (DKD) is the most common cause of end-stage kidney disease. Blood pressure (BP) control can reduce the risks of cardiovascular (CV) morbidity, mortality, and kidney disease progression. Recently, the Kidney Disease: Improving Global Outcomes (KDIGO) guidelines have suggested the implementation of a more intensive BP control with a target systolic BP (SBP) of <120 mmHg based on the evidence that the CV benefits obtained is outweighed by the kidney injury risk associated with a lower BP target. However, an extremely low BP level may paradoxically aggravate renal function and CV outcomes. Herein, we aimed to review the existing literature regarding optimal BP control using medications for DKD.</p>","PeriodicalId":35352,"journal":{"name":"Electrolyte and Blood Pressure","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/0a/02/ebp-20-39.PMC9827046.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9176493","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
Korean Society of Nephrology 2022 Recommendations on Controversial Issues in Diagnosis and Management of Hyponatremia. 韩国肾脏病学会2022年关于低钠血症诊断和管理争议问题的建议。
Electrolyte and Blood Pressure Pub Date : 2022-06-01 Epub Date: 2022-06-30 DOI: 10.5049/EBP.2022.20.1.21
Yeonhee Lee, Kyung Don Yoo, Seon Ha Baek, Yang Gyun Kim, Hyo Jin Kim, Ji Young Ryu, Jin Hyuk Paek, Sang Heon Suh, Se Won Oh, Jeonghwan Lee, Jong Hyun Jhee, Jin-Soon Suh, Eun Mi Yang, Young Ho Park, Yae Lim Kim, Miyoung Choi, Kook-Hwan Oh, Sejoong Kim
{"title":"Korean Society of Nephrology 2022 Recommendations on Controversial Issues in Diagnosis and Management of Hyponatremia.","authors":"Yeonhee Lee,&nbsp;Kyung Don Yoo,&nbsp;Seon Ha Baek,&nbsp;Yang Gyun Kim,&nbsp;Hyo Jin Kim,&nbsp;Ji Young Ryu,&nbsp;Jin Hyuk Paek,&nbsp;Sang Heon Suh,&nbsp;Se Won Oh,&nbsp;Jeonghwan Lee,&nbsp;Jong Hyun Jhee,&nbsp;Jin-Soon Suh,&nbsp;Eun Mi Yang,&nbsp;Young Ho Park,&nbsp;Yae Lim Kim,&nbsp;Miyoung Choi,&nbsp;Kook-Hwan Oh,&nbsp;Sejoong Kim","doi":"10.5049/EBP.2022.20.1.21","DOIUrl":"https://doi.org/10.5049/EBP.2022.20.1.21","url":null,"abstract":"<p><p>The Korean Society for Electrolyte and Blood Pressure Research, in collaboration with the Korean Society of Nephrology, has published a clinical practice guideline (CPG) document for hyponatremia treatment. The document is based on an extensive evidence-based review of the diagnosis, evaluation, and treatment of hyponatremia with the multidisciplinary participation of representative experts in hyponatremia with methodologist support for guideline development. This CPG consists of 12 recommendations (two for diagnosis, eight for treatment, and two for special situations) based on eight detailed topics and nine key questions. Each recommendation begins with statements graded by the strength of the recommendations and the quality of the evidence. Each statement is followed by rationale supporting the recommendations. The committee issued conditional recommendations in favor of rapid intermittent bolus administration of hypertonic saline in severe hyponatremia, the use of vasopressin receptor antagonists in heart failure with hypervolemic hyponatremia, and syndrome of inappropriate antidiuresis with moderate to severe hyponatremia, the individualization of desmopressin use, and strong recommendation on the administration of isotonic fluids as maintenance fluid therapy in hospitalized pediatric patients. We hope that this CPG will provide useful recommendations in practice, with the aim of providing clinical support for shared decision-making to improve patient outcomes.</p>","PeriodicalId":35352,"journal":{"name":"Electrolyte and Blood Pressure","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/90/ae/ebp-20-21.PMC9685326.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40711516","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: 6
Potassium Channel Syndrome Caused by Nicorandil in Chronic Kidney Disease: A Case Report and Literature Review. 尼可地尔致慢性肾病钾通道综合征1例并文献复习。
Electrolyte and Blood Pressure Pub Date : 2022-06-01 Epub Date: 2022-06-30 DOI: 10.5049/EBP.2022.20.1.17
Ji-Eun Kim, Seun Deuk Hwang, Seoung Woo Lee, Joon Ho Song, Kipyo Kim
{"title":"Potassium Channel Syndrome Caused by Nicorandil in Chronic Kidney Disease: A Case Report and Literature Review.","authors":"Ji-Eun Kim,&nbsp;Seun Deuk Hwang,&nbsp;Seoung Woo Lee,&nbsp;Joon Ho Song,&nbsp;Kipyo Kim","doi":"10.5049/EBP.2022.20.1.17","DOIUrl":"https://doi.org/10.5049/EBP.2022.20.1.17","url":null,"abstract":"<p><p>Nicorandil is an anti-anginal drug that is commonly used in the treatment of ischemic heart disease. Nicorandil acts as a nitrate donor and ATP-sensitive potassium channel agonist, inducing coronary artery vasodilation. Potassium efflux through ATP-sensitive potassium channels activated by nicorandil can cause refractory hyperkalemia, particularly in patients with chronic kidney disease (CKD). Here, we report the case of an 85-year-old man who presented with severe refractory hyperkalemia, despite proper medical management. His serum potassium level increased from 4.96 to 7.21 mEq/L 7 days after restarting nicorandil. Hyperkalemia resolved shortly after discontinuation of nicorandil, which was presumed to be the offending drug. Previously, a few cases reported nicorandil-induced hyperkalemia called potassium channel syndrome in patients with CKD, and hyperkalemia can be reversed by ceasing nicorandil or using sulfonyl urea drugs. Given that CKD patients may have several contributing factors to this adverse event, clinicians should be aware of the risk of nicorandil-induced hyperkalemia, and medication review and drug discontinuation should be considered.</p>","PeriodicalId":35352,"journal":{"name":"Electrolyte and Blood Pressure","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/48/76/ebp-20-17.PMC9685324.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40711515","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
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