Management of Hyperkalemia in Dialysis Patients

Putcha, Nirupama; Allon, Michael

doi:10.1111/j.1525-139x.2007.00312.x

Cited by 103 publications

(75 citation statements)

References 64 publications

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“…First Published Online in J-STAGE on April 23, 2016. * Corresponding author (E-mail: asao@life.shimane-u.ac.jp).and Allon, 2007). About 77% of dietary K is excreted in the urine via the kidneys (Holbrook et al, 1984).…”

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confidence: 99%

Reduction of Potassium (K) Content in Strawberry Fruits through KNO<sub>3</sub> Management of Hydroponics

et al. 2017

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The consumption of vegetables and fruits rich in potassium (K), such as melons and strawberries, is restricted in chronic kidney disease (CKD) patients. Therefore, we attempted to produce low-K strawberry fruits through management of a KNO 3 fertilizer in nutrient solution from anthesis to the harvest period. A general trend of decreasing K content in fruit was observed with the decrease of KNO 3 concentration in the nutrient solution. Among four strawberry cultivars, the fruit of the 'Toyonoka' exhibited a K reduction of about 64% when plants were grown in nutrient solution with KNO 3 at 1/16 of the normal level. Citric acid and ascorbic acid contents of 'Toyonoka' fruit were reduced with decreasing KNO 3 concentrations in the nutrient solution. Although the reduced NO 3 − of the nutrient solution was adjusted by using Ca(NO 3 ) 2 to obtain low-K strawberries, growth, yield, and quality did not vary with this adjustment. Compared with the typical level of K in strawberry fruit of 170 mg/100 g FW (Standard Tables of Food Composition in Japan, 2011), a 23.5% decrease (130 mg/100 g FW) in K was found in 1/32 level of KNO 3 . The K contents of plant parts suggested that the low KNO 3 level was responsible for the low K absorption, which may have affected the translocation and accumulation of K into fruit. Therefore, 1/32 level of KNO 3 in nutrient solution lowers the fruit K content considerably.Key Words: chronic kidney disease, Fragaria × ananassa Duch. 'Toyonoka', fruit potassium content, potassium nitrate, potassium translocation. IntroductionPotassium (K) is a major electrolyte in the human body. It plays an important role in the contraction or relaxation of skeletal, smooth, and cardiac muscles, nerve impulse transmission, acid base equilibrium, enzymatic action, intracellular fluid tonicity, and renal function (Crawford and Harris, 2011;Russell, 2009). The average daily K intake is estimated to be 2000-3900 mg·day −1 (Choi and Ha, 2013;Kes, 2001; Putcha Received; September 16, 2015. Accepted; March 6, 2016. First Published Online in J-STAGE on April 23, 2016. * Corresponding author (E-mail: asao@life.shimane-u.ac.jp).and Allon, 2007). About 77% of dietary K is excreted in the urine via the kidneys (Holbrook et al., 1984). A study found that higher K excretion is associated with a reduction in the risk of adverse renal outcomes (Smyth et al., 2014), but patients with chronic kidney disease (CKD) have limited ability to excrete K through the kidneys. As a result, the level of K increases in the blood serum. An elevated level of K in serum is called hyperkalemia, and is associated with an increased risk of chronic kidney disease progression and all-cause mortality in patients with chronic kidney disease . Mills et al. (2014) found that high dietary K was associated with an increased risk of cardiovascular disease among patients with CKD. In the United States, hyperkalemia causes 5 deaths/1000 person-years in patients with CKD (US Renal Data System, 2002). The number of CKD patients is continuing to increase g...

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Reduction of Potassium (K) Content in Strawberry Fruits through KNO<sub>3</sub> Management of Hydroponics

et al. 2017

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“…Hyperkaliämie ist in 2-5 % ursächlich für den Tod von Hämodialysepatienten [466] und führt in bis zu 24 % zu einer Notfalldialyse [467] …”

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Truhlář

Deakin

Soar

et al. 2015

Notfall Rettungsmed

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“…It has been hypothesized that the increase in sudden death after the 3-d delay between outpatient dialysis events may have its source in high K ϩ levels accrued during this period (13). Physiologically, this is not unexpected given the importance of K ϩ in maintaining the heart's resting membrane potential as well as its conductivity (12). Although often cited as a likely contributing factor to cardiac arrhythmias in patients with ESRD, surprisingly little in the scientific literature has directly evaluated K ϩ and/or K ϩ shifts in the setting of AMI.…”

Section: Discussionmentioning

confidence: 99%

“…In the outpatient population, predialysis K ϩ levels, either too low or too high (Ͻ4 or Ͼ5.6), carry an increased risk for morbidity and/or mortality (11). Hyperkalemia in dialysis patients is a common problem seen in 5 to 10% of patients per month and accounting for a mortality rate of 3.1 per 1000 patient-years (12). It has been hypothesized that the increase in sudden death after the 3-d delay between outpatient dialysis events may have its source in high K ϩ levels accrued during this period (13).…”

Section: Discussionmentioning

confidence: 99%

Does Timing of Dialysis in Patients with ESRD and Acute Myocardial Infarcts Affect Morbidity or Mortality?

Coritsidis

Sutariya

Stern

et al. 2009

Clinical Journal of the American Society of Nephrology

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Background and objectives: Patients with ESRD have an increased incidence of coronary events with a relatively higher risk for mortality after acute myocardial infarction (AMI). We evaluated whether it is safer to delay dialysis in AMI or if delay poses separate risks.Design, setting, participants, & measurements: We conducted a retrospective review of 131 long-term hemodialysis patients who had AMI and were admitted between 1997 and 2005 at three New York City municipal hospitals. Patients were separated into three groups on the basis of time between cardiac symptoms and first dialysis (<24 h, 24 to 48 h, and >48 h).Results: A total of 17 (13%) patients died, 10 (59%) of whom had either hypotension or an arrhythmia during their first cardiac care unit dialysis. Although these groups were comparable in acuity and cardiac status, there were no findings of increased morbidity (26, 36, and 20%, respectively) or mortality (11, 18, and 13%, respectively), despite differences in the timing of each group's dialysis. We found that previous cardiac disease, predialysis K ؉ , ⌬K ؉ after dialysis, and APACHE scores were

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Management of Hyperkalemia in Dialysis Patients

Cited by 103 publications

References 64 publications

Reduction of Potassium (K) Content in Strawberry Fruits through KNO<sub>3</sub> Management of Hydroponics

Reduction of Potassium (K) Content in Strawberry Fruits through KNO<sub>3</sub> Management of Hydroponics

Kreislaufstillstand in besonderen Situationen

Does Timing of Dialysis in Patients with ESRD and Acute Myocardial Infarcts Affect Morbidity or Mortality?

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