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Serum Potassium

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1. Effect of dialysate potassium and lactate on serum potassium and bicarbonate concentrations during daily hemodialysis at low dialysate flow rates. (PubMed)

Effect of dialysate potassium and lactate on serum potassium and bicarbonate concentrations during daily hemodialysis at low dialysate flow rates. Observational studies of hemodialysis patients treated thrice weekly have shown that serum and dialysate potassium and bicarbonate concentrations are associated with patient outcomes. The effect of more frequent hemodialysis on serum potassium and bicarbonate concentrations has rarely been studied, especially for treatments at low dialysate flow (...) rate.These post-hoc analyses evaluated data from patients who transferred from in-center hemodialysis (HD) to daily HD at low dialysate flow rates during the FREEDOM Study. The primary outcomes were the change in predialysis serum potassium and bicarbonate concentrations after transfer from in-center HD (mean during the last 3 months) to daily HD (mean during the first 3 months).After transfer from in-center HD to daily HD (data from 345 patients, 51 ± 15 years of age, mean ± standard deviation

2019 BMC Nephrology

2. Serum Potassium Levels and Risk of Sudden Cardiac Death Among Patients With Chronic Kidney Disease and Significant Coronary Artery Disease (PubMed)

Serum Potassium Levels and Risk of Sudden Cardiac Death Among Patients With Chronic Kidney Disease and Significant Coronary Artery Disease Chronic kidney disease (CKD) patients have increased risks of sudden cardiac arrest and sudden cardiac death (SCA/SCD) that are not explained by traditional risk factors. We examined associations between serum potassium and SCA/SCD in a large cohort of patients with coronary artery disease (CAD) and moderate CKD.Among 22,009 patients who underwent cardiac (...) with a doubling in SCA/SCD risk (adjusted odd ratio: 2.37; 95% confidence interval: 1.33-4.23) whereas there was no significant relationship between hypokalemia and outcome.Among CKD patients with significant CAD, elevated serum potassium levels >5.0 mEq/l are common and are associated with an increased short-term risk of SCA/SCD. Early detection and treatment of hyperkalemia may reduce the high risk of SCD among CKD patients.

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2017 Kidney international reports

3. Prognostic role of serum sodium levels across different serum potassium levels in heart failure patients: A Danish register-based cohort study. (PubMed)

Prognostic role of serum sodium levels across different serum potassium levels in heart failure patients: A Danish register-based cohort study. In heart failure (HF), evidence on the prognosis of simultaneously abnormal sodium and potassium levels remains unknown. Therefore, we investigated associations between sodium levels and 90-day all-cause mortality across potassium levels in HF patients.Using Danish registers, we identified HF patients with sodium and potassium levels within 90 days (...) following a redeemed loop diuretic prescription from 2000 to 2012. We grouped sodium (<139, 139-143, >143 mmol/L) and potassium levels (<3.5 [hypokalemia], 3.5-4.0, 4.1-4.6, 4.7-5.0, >5.0 mmol/L [hyperkalemia]). First, by adjusting for potassium groups using multivariable Cox regression, we compared mortality of sodium <139 mmol/L and >143 mmol/L with 139-143 mmol/L as reference. Second, by combining sodium and potassium groups, we compared mortality of the resulting 15 combinations using sodium 139

2018 International journal of cardiology

4. The association of concomitant serum potassium and glucose levels and in-hospital mortality in patients with acute myocardial infarction (AMI). Soroka acute myocardial infarction II (SAMI-II) project. (PubMed)

The association of concomitant serum potassium and glucose levels and in-hospital mortality in patients with acute myocardial infarction (AMI). Soroka acute myocardial infarction II (SAMI-II) project. Acute myocardial infarction (AMI) is associated with significant systemic metabolic changes. These changes include increased plasma concentrations of counter-regulatory hormones and changes in potassium (K, mEq/L) and glucose (mg/dL) levels. The latter are associated with outcomes and investigated (...) as potential focus for intervention; glucose-insulin‑potassium (GIK) solution.To evaluate the associations of concomitant K and glucose (K/glucose) levels with in-hospital mortality in AMI patients.AMI patients hospitalized in a tertiary Medical Center through 2002-2012 were studied. K/glucose levels were divided into equally sized categories. The intermediate category (glucose 124-143 mg/dL, K 4-4.9 mEq/L) was the reference group. The associations of these tests with the outcome were assessed using

2019 International journal of cardiology

5. Cut-off values of serum potassium and core temperature at hospital admission for extracorporeal rewarming of avalanche victims in cardiac arrest: A retrospective multi-centre study. (PubMed)

Cut-off values of serum potassium and core temperature at hospital admission for extracorporeal rewarming of avalanche victims in cardiac arrest: A retrospective multi-centre study. Evidence of existing guidelines for the on-site triage of avalanche victims is limited and adherence suboptimal. This study attempted to find reliable cut-off values for the identification of hypothermic avalanche victims with reversible out-of-hospital cardiac arrest (OHCA) at hospital admission. This may enable (...) values, and receiver operating curves.In total, 103 avalanche victims with OHCA were included. Of the 103 patients 61 (58%) were rewarmed by ECLS. Six (10%) of the rewarmed patients survived whilst 55 (90%) died. We obtained optimal cut-off values of 7 mmol/L for serum potassium and 30 °C for core temperature.For in-hospital triage of avalanche victims admitted with OHCA, serum potassium accurately predicts survival. The combination of the cut-offs 7 mmol/L for serum potassium and 30 °C for core

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2019 Resuscitation

6. Effects of Dexmedetomidine on Blood Glucose and Serum Potassium Levels in Children Undergoing General Anesthesia: A Secondary Analysis of Safety Endpoints During a Randomized Controlled Trial. (PubMed)

Effects of Dexmedetomidine on Blood Glucose and Serum Potassium Levels in Children Undergoing General Anesthesia: A Secondary Analysis of Safety Endpoints During a Randomized Controlled Trial. Dexmedetomidine is a highly selective α2-adrenergic agonist, which is increasingly used in pediatric anesthesia and intensive care. Potential adverse effects that have not been rigorously evaluated in children include its effects on blood glucose and serum potassium concentrations, which are relevant due (...) . Changes in plasma glucose and serum potassium concentrations were measured in venous blood sampled before and at 15 and 30 minutes after study drug administration. Data were plotted within and between groups and analyzed using a constrained longitudinal data approach.Forty-nine children completed the study. Mean glucose levels at 15 and 30 minutes were elevated with estimated changes from baseline of 0.37 mmol/L (95% CI, 0.29-0.45 mmol/L) and 0.05 mmol/L (95% CI, 0.00-0.10 mmol/L), respectively. At 15

2019 Anesthesia and Analgesia Controlled trial quality: uncertain

7. Examining the "Repletion Reflex": The Association between Serum Potassium and Outcomes in Hospitalized Patients with Heart Failure. (PubMed)

Examining the "Repletion Reflex": The Association between Serum Potassium and Outcomes in Hospitalized Patients with Heart Failure. In patients hospitalized with heart failure (HF) exacerbations, physicians routinely supplement potassium to maintain levels ≥4.0 mEq/L. The evidence basis for this practice is relatively weak. We aimed to evaluate the association between serum potassium levels and outcomes in patients hospitalized with HF.We identified patients admitted with acute HF exacerbations (...) to hospitals that contributed to an electronic health record-derived dataset. In a subset of patients with normal admission serum potassium (3.5-5.0 mEq/L), we averaged serum potassium values during a 72-hour exposure window and categorized as follows: <4.0 mEq/L (low normal), 4.0-4.5 mEq/L (medium normal), and >4.5 mEq/L (high normal). We created multivariable models examining associations between these categories and outcomes.We included 4,995 patients: 2,080 (41.6%), 2,326 (46.6%), and 589 (11.8

2019 Journal of Hospital Medicine

8. Admission serum sodium and potassium levels predict survival among critically ill patients with acute kidney injury: a cohort study. (PubMed)

Admission serum sodium and potassium levels predict survival among critically ill patients with acute kidney injury: a cohort study. Patients suffering from acute kidney injury (AKI) were associated with impaired sodium and potassium homeostasis. We aimed to investigate how admission serum sodium and potassium independently and jointly modified adverse clinical outcomes among AKI patients.Patient data were extracted from the Multiparameter Intelligent Monitoring in Intensive Care Database III (...) . Participants were categorized into three groups according to admission serum sodium and potassium, and the cut-off values were determined using smooth curve fitting. The primary outcome was 90-day mortality in the intensive care unit (ICU). Cox proportional hazards models were used to evaluate the prognostic effects of admission serum sodium and potassium levels.We included 13,621 ICU patients with AKI (mean age: 65.3 years; males: 55.4%). The middle category of admission serum sodium and potassium levels

2019 BMC Nephrology

9. Associations between serum potassium and adverse clinical outcomes: a systematic literature review. (PubMed)

Associations between serum potassium and adverse clinical outcomes: a systematic literature review. Despite the growing body of evidence characterising the association between serum potassium levels and adverse clinical outcomes, a contemporary summary of available evidence is currently lacking. The objective of this study, therefore, was to undertake a systematic literature review to identify all relevant evidence assessing risk factors associated with the incidence of hyperkalaemia (HK (...) ) and also quantifying the effect of serum potassium levels on risk of adverse clinical outcomes.PubMed (Medline and Medline In-Process), Embase and the Cochrane Library were searched for studies published between January 2002 and November 2018. Search inclusion criteria included studies describing either the incidence of HK events and any associated risk factors, or associations between HK or serum potassium concentration and adverse clinical outcomes including mortality, hospitalisation, major adverse

2019 International journal of clinical practice

10. Racial and Ethnic Differences in Mortality Associated with Serum Potassium in Incident Peritoneal Dialysis Patients. (PubMed)

Racial and Ethnic Differences in Mortality Associated with Serum Potassium in Incident Peritoneal Dialysis Patients. Abnormalities in serum potassium are risk factors for sudden cardiac death and arrhythmias among dialysis patients. Although a previous study in hemodialysis patients has shown that race/ethnicity may impact the relationship between serum potassium and mortality, the relationship remains unclear among peritoneal dialysis (PD) patients where the dynamics of serum potassium is more (...) stable.Among 17,664 patients who started PD between January 1, 2007 and December 31, 2011 in a large US dialysis organization, we evaluated the association of serum potassium levels with all-cause and arrhythmia-related deaths across race/ethnicity using time-dependent Cox models with adjustments for demographics. We also used restricted cubic spline functions for serum potassium levels to explore non-linear associations.Baseline serum potassium levels were the highest among Hispanics (4.2 ± 0.7 mEq/L

2019 American journal of nephrology

11. Evaluation of Serum Lipid, Thyroid, and Hepatic Clinical Chemistries in Association With Serum Perfluorooctanesulfonate (PFOS) in Cynomolgus Monkeys After Oral Dosing With Potassium PFOS (PubMed)

Evaluation of Serum Lipid, Thyroid, and Hepatic Clinical Chemistries in Association With Serum Perfluorooctanesulfonate (PFOS) in Cynomolgus Monkeys After Oral Dosing With Potassium PFOS An oral dose study with perfluorooctanesulfonate (PFOS) was undertaken to identify potential associations between serum PFOS and changes in serum clinical chemistry parameters in purpose-bred young adult cynomolgus monkeys (Macaca fascicularis). In this study, control group (n = 6/sex) was sham-dosed (...) for coagulation, lipids, hepatic, renal, electrolytes, and thyroid-related hormones. No mortality occurred during the study. All the monkeys were healthy, gained weight, and were released back to the colony at the end of the study. The highest serum PFOS achieved was approximately 165 μg/ml. When compared with time-matched controls, administration of K+PFOS to monkeys did not result in any toxicologically meaningful or clinically relevant changes in serum clinical measurements for coagulation, lipids, hepatic

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2017 Toxicological Sciences

12. Lower serum potassium associated with increased mortality in dialysis patients: A nationwide prospective observational cohort study in Korea. (PubMed)

Lower serum potassium associated with increased mortality in dialysis patients: A nationwide prospective observational cohort study in Korea. Abnormal serum potassium concentration has been suggested as a risk factor for mortality in patients undergoing dialysis patients. We investigated the impact of serum potassium levels on survival according to dialysis modality.A nationwide, prospective, observational cohort study for end stage renal disease patients has been ongoing in Korea since August (...) 2008. Our analysis included patients whose records contained data regarding serum potassium levels. The relationship between serum potassium and mortality was analyzed using competing risk regression.A total of 3,230 patients undergoing hemodialysis (HD, 64.3%) or peritoneal dialysis (PD, 35.7%) were included. The serum potassium level was significantly lower (P < 0.001) in PD (median, 4.5 mmol/L; interquartile range, 4.0-4.9 mmol/L) than in HD patients (median, 4.9 mmol/L; interquartile range, 4.5

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2017 PLoS ONE

13. Dialysate Potassium, Serum Potassium, Mortality, and Arrhythmia Events in Hemodialysis: Results From the Dialysis Outcomes and Practice Patterns Study (DOPPS). (PubMed)

Dialysate Potassium, Serum Potassium, Mortality, and Arrhythmia Events in Hemodialysis: Results From the Dialysis Outcomes and Practice Patterns Study (DOPPS). Sudden death is a leading cause of death in patients on maintenance hemodialysis therapy. During hemodialysis sessions, the gradient between serum and dialysate levels results in rapid electrolyte shifts, which may contribute to arrhythmias and sudden death. Controversies exist about the optimal electrolyte concentration in the dialysate (...) (arrhythmia-related hospitalization or sudden death), adjusting for potential confounders.During a median follow-up of 16.5 months, 24% of patients died and 7% had an arrhythmia composite outcome. No meaningful difference in clinical outcomes was observed for patients treated with a dialysate potassium concentration of 3 versus 2 mEq/L (adjusted HRs were 0.96 [95% CI, 0.91-1.01] for mortality and 0.98 [95% CI, 0.88-1.08] for arrhythmia composite). Results were similar across predialysis serum potassium

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2016 American Journal of Kidney Diseases

14. Gastrointestinal potassium binding-more than just lowering serum [K(+)]: patiromer, potassium balance, and the renin angiotensin aldosterone axis. (PubMed)

Gastrointestinal potassium binding-more than just lowering serum [K(+)]: patiromer, potassium balance, and the renin angiotensin aldosterone axis. Hyperkalemia limits the use of renin-angiotensin-aldosterone axis (RAAS) blockers in patients with renal insufficiency. This can be managed by efforts to increase kaliuresis and by gastrointestinal potassium binding with sodium polystyrene sulfonate, a relatively ineffective agent. Now with the availability of patiromer, RAAS blockers can be used (...) more liberally. In addition, potassium reduction decreases aldosterone, which may be beneficial. Adverse nonepithelial aldosterone effects such as endothelial dysfunction and cardiac fibrosis may be ameliorated.Copyright © 2016 International Society of Nephrology. Published by Elsevier Inc. All rights reserved.

2016 Kidney International

15. Systematic review and meta-analysis of randomised controlled trials on the effects of potassium supplements on serum potassium and creatinine. (PubMed)

Systematic review and meta-analysis of randomised controlled trials on the effects of potassium supplements on serum potassium and creatinine. High potassium intake could prevent stroke, but supplementation is considered hazardous. We assessed the effect of oral potassium supplementation on serum or plasma potassium levels and renal function.We updated a systematic review of the effects of potassium supplementation in randomised clinical trials carried out worldwide, published in 2013 (...) , extending it to July 2015. We followed the PRISMA guidelines.Any individual taking part in a potassium supplementation randomised clinical trial. Studies included met the following criteria: randomised clinical trials, potassium supplement given and circulating potassium levels reported.Oral potassium supplementation.Serum or plasma potassium and serum or plasma creatinine.A total of 20 trials (21 independent groups) were included (1216 participants from 12 different countries). All but 2 were

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2016 BMJ open

16. Association of serum potassium concentration with mortality and ventricular arrhythmias in patients with acute myocardial infarction: A systematic review and meta-analysis.

Association of serum potassium concentration with mortality and ventricular arrhythmias in patients with acute myocardial infarction: A systematic review and meta-analysis. Background Challenging clinical practice guidelines that recommend serum potassium concentration between 4.0-5.0 mEq/L or ≥4.5 mEq/L in patients with acute myocardial infarction, recent studies found increased mortality risks in patients with a serum potassium concentration of ≥4.5 mEq/L. Studies investigating consequences (...) of hypokalemia after acute myocardial infarction revealed conflicting results. Therefore, the aim of this systematic review and meta-analysis was to combine evidence from previous studies on the association of serum potassium concentration with both short and long-term mortality as well as the occurrence of ventricular arrhythmias. Design Systematic review and meta-analysis. Methods A structured search of MEDLINE and EMBASE databases yielded 23 articles published between 1990 and January 2017 that met

2018 European journal of preventive cardiology

17. Serum potassium and adverse outcomes across the range of kidney function: a CKD Prognosis Consortium meta-analysis. (PubMed)

Serum potassium and adverse outcomes across the range of kidney function: a CKD Prognosis Consortium meta-analysis. Both hypo- and hyperkalaemia can have immediate deleterious physiological effects, and less is known about long-term risks. The objective was to determine the risks of all-cause mortality, cardiovascular mortality, and end-stage renal disease associated with potassium levels across the range of kidney function and evaluate for consistency across cohorts in a global consortium.We (...) participants followed up for a mean of 6.9 years. The average age was 55 ± 16 years, average eGFR was 83 ± 23 mL/min/1.73 m2, and 17% had moderate- to-severe increased albuminuria levels. The mean baseline potassium was 4.2 ± 0.4 mmol/L. The risk of serum potassium of >5.5 mmol/L was related to lower eGFR and higher albuminuria. The risk relationship between potassium levels and adverse outcomes was U-shaped, with the lowest risk at serum potassium of 4-4.5 mmol/L. Compared with a reference of 4.2 mmol/L

2018 European Heart Journal

18. Impact of Different Serum Potassium Levels on Postresuscitation Heart Function and Hemodynamics in Patients with Nontraumatic Out-of-Hospital Cardiac Arrest (PubMed)

Impact of Different Serum Potassium Levels on Postresuscitation Heart Function and Hemodynamics in Patients with Nontraumatic Out-of-Hospital Cardiac Arrest Sustained return of spontaneous circulation (ROSC) can be initially established in patients with out-of-hospital cardiac arrest (OHCA); however, the early postresuscitation hemodynamics can still be impaired by high levels of serum potassium (hyperkalemia). The impact of different potassium levels on early postresuscitation heart function (...) has remained unclear. We aim to analyze the relationship between different levels of serum potassium and postresuscitation heart function during the early postresuscitation period (the first hour after achieving sustained ROSC).Information on 479 nontraumatic OHCA patients with sustained ROSC was retrospectively obtained. Measures of early postresuscitation heart function (rate, blood pressure, and rhythm), hemodynamics (urine output and blood pH), and the duration of survival were analyzed

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2018 Bioinorganic chemistry and applications

19. Serum potassium levels and outcomes in critically ill patients in the medical intensive care unit (PubMed)

Serum potassium levels and outcomes in critically ill patients in the medical intensive care unit Objective To compare the outcomes of patients with and without a mean serum potassium (K+) level within the recommended range (3.5-4.5 mEq/L). Methods This prospective cohort study involved patients admitted to the medical intensive care unit (ICU) of Siriraj Hospital from May 2012 to February 2013. The patients' baseline characteristics, Acute Physiology and Chronic Health Evaluation II (APACHE II (...) ) score, serum K+ level, and hospital outcomes were recorded. Patients with a mean K+ level of 3.5 to 4.5 mEq/L and with all individual K+ values of 3.0 to 5.0 mEq/L were allocated to the normal K+ group. The remaining patients were allocated to the abnormal K+ group. Results In total, 160 patients were included. Their mean age was 59.3±18.3 years, and their mean APACHE II score was 21.8±14.0. The normal K+ group comprised 74 (46.3%) patients. The abnormal K+ group had a significantly higher mean

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2018 The Journal of international medical research

20. Study in HFpEF Patients to Compare the Effect of AZD9977 and Spironolactone on Serum Potassium

Study in HFpEF Patients to Compare the Effect of AZD9977 and Spironolactone on Serum Potassium Study in HFpEF Patients to Compare the Effect of AZD9977 and Spironolactone on Serum Potassium - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one (...) or more studies before adding more. Study in HFpEF Patients to Compare the Effect of AZD9977 and Spironolactone on Serum Potassium The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. of clinical studies and talk to your health care provider before participating. Read our for details. ClinicalTrials.gov Identifier: NCT03682497 Recruitment Status : Recruiting

2018 Clinical Trials

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