Purpose Of Review: Hyperkalemia is a potentially fatal electrolyte abnormality with no standardized management. The purpose of this review is to provide the knowledge needed for timely and effective management of hyperkalemia in children. It describes the utility of existing and novel therapies.
Recent Findings: Two newer oral potassium binding agents, patiromer sorbitex calcium and sodium zirconium cyclosilicate, have been FDA-approved for the management of hyperkalemia in adults. These newer agents offer hope for improved management, even though their use in pediatric patients requires further exploration.
Summary: This review highlights the causes and life-threatening effects of hyperkalemia and provides a comprehensive overview of the management of hyperkalemia in both acute and chronic settings along with upcoming treatment strategies.
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http://dx.doi.org/10.1097/MOP.0000000000001321 | DOI Listing |
Sci Rep
January 2025
Department of Pediatrics, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasama, Yufu, Oita, 879-5593, Japan.
In the management of pregnancy, ritodrine has been used to prevent preterm birth, and magnesium sulfate (MgSO) has been used to prevent preterm labor and preeclampsia. Neonates born to mothers receiving these medications occasionally show an increase in serum potassium concentration. Recently, an elevated risk of neonatal hyperkalemia has been reported, particularly when ritodrine and MgSO are co-administered; however, the underlying mechanisms remain unclear.
View Article and Find Full Text PDFBackground: Hyperkalemia, generally defined as serum potassium levels greater than 5.0 mEq/L, poses significant clinical risks, including cardiac toxicity and muscle weakness. Its prevalence and severity increase in patients with chronic kidney disease (CKD), diabetes mellitus, and heart failure (HF), particularly when compounded by medications like Angiotensin converting inhibitors, Angiotensin receptor blockers, and potassium sparing diuretics.
View Article and Find Full Text PDFJ Clin Med
December 2024
Cardiology Department, Hospital Universitario Lucus Augusti, 27003 Lugo, Spain.
: Hyperkalemia is a common electrolyte disorder in patients with heart failure and reduced ejection fraction (HFrEF). Renin-angiotensin-aldosterone system inhibitors (RAASi) have been shown to improve survival and decrease hospitalization rates, although they may increase the serum potassium levels. Hyperkalemia has significant clinical and economic implications, and is associated with increased healthcare resource utilization.
View Article and Find Full Text PDFClin Kidney J
January 2025
Division of Nephrology, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA.
The mineralocorticoid receptor (MR) is a nuclear transcription factor that plays a critical role in regulating fluid, electrolytes, blood pressure, and hemodynamic stability. In conditions such as chronic kidney disease (CKD) and heart failure (HF), MR overactivation leads to increased salt and water retention, inflammatory and fibrotic gene expression, and organ injury. The MR is essential for transcriptional regulation and is implicated in metabolic, proinflammatory, and pro-fibrotic pathways.
View Article and Find Full Text PDFElectrolyte Blood Press
December 2024
Department of Internal Medicine, Chung-Ang University, Seoul, Republic of Korea.
Diabetic kidney disease (DKD) is a leading cause of chronic kidney disease (CKD). Recent advancements highlight the role of finerenone, a non-steroidal mineralocorticoid receptor antagonist (nsMRA), in DKD management. Studies like FIDELIO-DKD, FIGARO-DKD, and FIDELITY have demonstrated finerenone's efficacy in reducing CKD progression and cardiovascular risks in DKD patients.
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