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Background: If C is creatinine clearance, a surrogate for glomerular filtration rate (GFR), the serum potassium concentration (K) is the sum of E/C and TR/C, which are amounts of potassium excreted and (net) reabsorbed per volume of filtrate (K = E/C + TR/C). We investigated changes in E/C, TR/C, and K through the stages of chronic kidney disease (CKD).
Materials And Methods: We performed a retrospective study of 452 patients with CKD stages G1 - 5.
Thyrotoxic Periodic Paralysis: A Rare Cause of Quadriparesis in a Young and Seemingly Healthy Patient.
Medicina (Kaunas)
October 2024
Department of Internal Medicine, Clinical Emergency Hospital of Bucharest, 105402 Bucharest, Romania.
Hypokalemia is a common laboratory finding in hospitalized patients, typically resulting from insufficient potassium intake, renal or gastrointestinal losses, or intracellular shifts. While the underlying cause is often easily identifiable, certain cases present diagnostic challenges, and if left unrecognized, the consequences can be life-threatening. We report a rare and atypical case of severe symptomatic hypokalemia as the initial presentation of newly diagnosed Graves' disease.
View Article and Find Full Text PDFThe Paradox of Hyperkalaemia: When Treatment Isn't the Answer.
Cureus
September 2024
Acute and General Internal Medicine, University Hospitals Bristol and Weston, Weston-super-Mare, GBR.
Article Synopsis
- Hyperkalaemia is a serious medical emergency that requires immediate treatment, but there is uncertainty about the exact level at which treatment should start due to different clinical situations.
- The case report focuses on an 89-year-old man with frequent falls and unstable potassium levels, who did not exhibit symptoms of hyperkalaemia and lacked a significant drug history.
- Further examination identified a myeloproliferative neoplasm causing thrombocytosis, leading to a diagnosis of pseudohyperkalaemia, which emphasizes the importance of distinguishing between true hyperkalaemia and pseudohyperkalaemia in patients with blood disorders.
Treatment Challenges and Controversies in the Management of Critically Ill Diabetic Ketoacidosis (DKA) Patients in Intensive Care Units.
Cureus
September 2024
Pulmonary and Critical Care Medicine, East Carolina University Brody School of Medicine, Greenville, USA.
Article Synopsis
- * Isotonic normal saline is standard for initial fluid resuscitation, but balanced solutions can help DKA resolve quicker; continuous IV insulin is preferred after stabilizing fluids and electrolytes.
- * The review warns against rapid hyperglycemia correction leading to cerebral edema, recommends close monitoring of electrolytes, and suggests that early oral nutrition can shorten hospital stays; intubation is preferred for respiratory failure management, while routine sodium bicarbonate use is generally discouraged.
Subtype Identification of Surgically Curable Primary Aldosteronism During Treatment With Mineralocorticoid Receptor Blockade.
Hypertension
June 2024
Internal Emergency Medicine Unit, Department of Medicine, Specialized Center for Blood Pressure Disorders-Regione Veneto (G.P., T.M.S., D.B., B.C., G.C., G.R., G.P.R.), University of Padova, Italy.
Background: Current guidelines and consensus documents recommend withdrawal of mineralocorticoid receptor antagonists (MRAs) before primary aldosteronism (PA) subtyping by adrenal vein sampling (AVS), but this practice can cause severe hypokalemia and uncontrolled high blood pressure. Our aim was to investigate if unilateral PA can be identified by AVS during MRA treatment.
Methods: We compared the rate of unilateral PA identification between patients with and without MRA treatment in large data sets of patients submitted to AVS while off renin-angiotensin system blockers and β-blockers.
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