Acid-Base and Electrolyte Managements in Chronic Kidney Disease and End-Stage Renal Disease: Case-Based Discussion

Lin, Jing; Zhang, Cheng; Ding, Xiaoqiang; Qian, Qi

doi:10.1159/000485155

Cited by 10 publications

(7 citation statements)

References 42 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Two common adverse occurrences in CKD and ESRD are hyperkalemia and hyperphosphatemia. Recurring symptoms and signs of hyperkalemia span from muscle weakness to paresthesia, paralysis, cardiac arrhythmias, and cardiac arrest [ 59 ]. The most common first-line treatment for hyperkalemia includes cellular membrane stabilization by administration of intravenous salts, and second-line treatment includes shifting potassium from the extracellular to the intracellular compartment through the administration of insulin and β-adrenergic agonists [ 60 ].…”

Section: Therapeutic Strategies For Chronic Kidney Disease Aimed At R...mentioning

confidence: 99%

Pathomechanism of oxidative stress in cardiovascularrenal remodeling and therapeutic strategies

Ravarotto

Bertoldi

Stefanelli

et al. 2022

Kidney Res Clin Pract

View full text Add to dashboard Cite

The high prevalence of cardiovascular disease in patients with chronic kidney disease indicates significant interactions between pathogenic pathways operating in the kidney and heart. These interactions involve all cell types (endothelial cells, smooth muscle cells, macrophages, and others), components of the vasculature, glomeruli, and heart that are susceptible to oxidative damage and structural alterations. A vicious cycle occurs whereby harmful factors such as reactive oxygen species and inflammation damage of vascular structures that themselves become sources of additional dangerous/toxic components released into the local environment. The evidence of this vicious cycle in chronic kidney disease should therefore lead to add other factors to both traditional and nontraditional risk factors. This review will examine the processes occurring during progressive kidney dysfunction with regard to vascular injury, renal remodeling, cardiac hypertrophy, and the transversal role of oxidative stress in the development of these complications.

show abstract

Section: Therapeutic Strategies For Chronic Kidney Disease Aimed At R...mentioning

confidence: 99%

Pathomechanism of oxidative stress in cardiovascularrenal remodeling and therapeutic strategies

Ravarotto

Bertoldi

Stefanelli

et al. 2022

Kidney Res Clin Pract

View full text Add to dashboard Cite

show abstract

“…Hypokalemia, however, was no longer associated with all‐cause mortality and only modestly with cardiovascular mortality 3 . While the pathogenesis of hyperkalemia in end‐stage renal disease (ESRD) is mainly based on diet, medication, and reduced potassium excretion with failing kidney function, 4 intradialytic management remains a clinical challenge. Intradialytic potassium removal essentially occurs in the first 2 hours of HD treatment and is driven by convective and diffusive transfer.…”

Section: Potassium Managementmentioning

confidence: 99%

Hemodialysis treatment in patients with severe electrolyte disorders: Management of hyperkalemia and hyponatremia

Pirklbauer

2020

Hemodialysis International

View full text Add to dashboard Cite

Significant deviations of serum potassium and sodium levels are frequently observed in hospitalized patients and are both associated with increased all‐cause and cardiovascular mortality. The presence of acute or chronic renal failure facilitates the pathogenesis and complicates the clinical management. In the absence of reliable outcome data in the context of dialysis prescription, requirement of renal replacement therapy in patients with severe electrolyte disturbances constitutes a therapeutic challenge. Recommendations for intradialytic management are based on pathophysiologic reasoning and clinical observations only, and as such, heterogeneous and limited to expert opinion level. This article reviews current strategies for the management of severe hyperkalemia and hyponatremia in hemodialysis patients.

show abstract

“…Patients with ESKD undergo chronic hemodialysis and often suffer from dry mouth. Chronic hemodialysis has additional side effects due to the changes in blood volume that occur over the course of treatment: blood pressure fluctuations, which can lead to interdialytic hypertension; alterations in electrolytes, such as sodium; and fluctuations in biochemicals, such as albumin, blood urea nitrogen (BUN) and creatine (Cr); and weight gain [3]. Therefore, a critical component for optimizing outcomes of hemodialysis is fluid control, which can also influence saliva flow rate.…”

Section: Introductionmentioning

confidence: 99%

Effects of hemodialysis treatment on saliva flow rate and saliva composition during in-center maintenance dialysis: a cross-sectional study

Liu

Fang

2020

Renal Failure

View full text Add to dashboard Cite

Aim: To analyze changes in saliva flow rate and clinical measures from unstimulated whole saliva (UWS) among patients undergoing hemodialysis for end-stage kidney disease (ESKD). Background: Chronic hemodialysis causes changes in blood chemistry as well as dry mouth, due to removal of excess fluids. UWS is used to examine saliva flow rate as an indicator of mouth dryness. Whether UWS can be used to measure changes in clinical variables following hemodialysis has not been explored. Design: A cross-sectional quantitative study. Methods: Patients with ESKD were recruited by purposive sampling (n ¼ 100) between 1 January and 30 June 2015 from a hospital in northern Taiwan. UWS was collected 1-hour pre-dialysis (T1), mid-dialysis (T2), and 1-hour post-dialysis (T3). Saliva flow rate and clinical variables were analyzed. Results: Saliva flow rate increased significantly from T1 to T3 (Wald v 2 ¼ 10.40, p < .01). Changes in saliva from T1 to T3 included decreases in blood urea nitrogen and creatinine (Wald v 2 ¼ 97.12, p < .001 and Wald v 2 ¼ 36.98, p < .001, respectively). The pH and osmolality also decreased (p < .001 and p < .01, respectively). Changes in electrolytes included decreases in potassium and calcium (Wald v 2 ¼ 6.71, p < .05 and Wald v 2 ¼ 17.64, p < .01, respectively) and increases in chloride (Wald v 2 ¼ 17.64, p < .001). Conclusion: Our findings demonstrated saliva flow rate and several saliva components were altered during hemodialysis. The total volume of saliva secretion increased following dialysis, which can reduce xerostomia. Therefore, medical personnel could provide interventions of relieving dry mouth symptoms and increasing saliva flow rate before hemodialysis treatment.

show abstract

Acid-Base and Electrolyte Managements in Chronic Kidney Disease and End-Stage Renal Disease: Case-Based Discussion

Cited by 10 publications

References 42 publications

Pathomechanism of oxidative stress in cardiovascularrenal remodeling and therapeutic strategies

Pathomechanism of oxidative stress in cardiovascularrenal remodeling and therapeutic strategies

Hemodialysis treatment in patients with severe electrolyte disorders: Management of hyperkalemia and hyponatremia

Effects of hemodialysis treatment on saliva flow rate and saliva composition during in-center maintenance dialysis: a cross-sectional study

Contact Info

Product

Resources

About