Hyperkalemia in Predialysis Patients

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Editorial Hyperkalemia in Predialysis Patients

Potassium homeostasis is generally well maintained in patients with advanced CKD until the GFR falls below 10–15 ml/min. Loss of nephron mass is counterbalanced by an adaptive increase in the secretory rate of K1 in remaining nephrons, such that fractional excretion of K1 is increased. In a study of normokalemic patients with stage 4 CKD, the fractional excretion of K1 was 126% compared with 26...

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Prevalence and factors associated with hyperkalemia in predialysis patients followed in a low-clearance clinic.

BACKGROUND AND OBJECTIVES Recent studies evaluated the prevalence of hyperkalemia and related risk factors in patients with CKD of various stages, but there is limited relevant information in predialysis patients. This study aimed to examine the prevalence and factors associated with hyperkalemia in the structured environment of a low-clearance clinic. DESIGN, SETTING, PARTICIPANTS, & MEASURE...

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Management of hyperkalemia in dialysis patients.

Hyperkalemia is common in patients with end-stage renal disease, and may result in serious electrocardiographic abnormalities. Dialysis is the definitive treatment of hyperkalemia in these patients. Intravenous calcium is used to stabilize the myocardium. Intravenous insulin and nebulized albuterol lower serum potassium acutely, by shifting it into the cells. Despite their widespread use, neith...

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Abnormalities of endothelial function in patients with predialysis renal failure.

BACKGROUND Endothelial dysfunction plays an important role in the development of atherosclerotic vascular disease, which is the leading cause of mortality in patients with chronic renal failure. OBJECTIVE To examine the relation between predialysis renal failure and endothelial function. DESIGN Two groups were studied: 80 patients with non-diabetic chronic renal failure and 26 healthy contr...

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Should erythropoiesis-stimulating agents be used in predialysis patients?

Anemia results from insufficient production of erythropoietin by the kidneys and is a common complication of chronic kidney disease. It is present in most patients with stage 4 and 5 chronic kidney disease. Studies have linked untreated anemia in chronic kidney disease to worsening cardiovascular complications, possible acceleration to end-stage renal disease, and death. Administration of eryth...

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ژورنال

عنوان ژورنال: Clinical Journal of the American Society of Nephrology

سال: 2012

ISSN: 1555-9041,1555-905X

DOI: 10.2215/cjn.06060612