Abstract:
:Hyperkalemia is a potentially life-threatening complication of chronic kidney disease (CKD). The management of CKD requires balancing the benefits of specific treatments, which may exacerbate the potential for hyperkalemia, with the risks of hyperkalemia itself. Renin-angiotensin-aldosterone system (RAAS) inhibitors, which slow CKD progression and improve cardiovascular outcomes, are often discontinued if hyperkalemia develops. Patients with hyperkalemia are frequently advised to restrict dietary potassium (K+), depriving these patients of many heart-healthy foods. Patients receiving hemodialysis are particularly susceptible to hyperkalemia during long interdialytic intervals, and managing this risk without causing hypokalemia can be challenging. Recently, 2 K+-binding agents were approved for the treatment of hyperkalemia: sodium zirconium cyclosilicate and patiromer. These agents offer alternatives to sodium polystyrene sulfonate, which is associated with serious gastrointestinal adverse effects. For this review, PubMed was searched for English-language articles published in 2014-2018 using the terms patiromer, sodium zirconium cyclosilicate, sodium polystyrene sulfonate, hyperkalemia, renin-angiotensin-aldosterone, diet, and dialysis. In randomized controlled studies of patients with hyperkalemia, sodium zirconium cyclosilicate and patiromer effectively reduced serum K+ and were generally well tolerated. Furthermore, patients in these studies could maintain RAAS inhibitor therapy and, in some studies, were not required to limit dietary K+. There may also be a role for these agents in preventing hyperkalemia in patients receiving hemodialysis. Thus, K+-binding agents may allow patients with CKD at risk for hyperkalemia to optimize RAAS inhibitor therapy, receive benefits of a K+-rich diet, and experience improved hemodialysis outcomes. Additional long-term studies are necessary to confirm these effects.
journal_name
Mayo Clin Procjournal_title
Mayo Clinic proceedingsauthors
Palmer BFdoi
10.1016/j.mayocp.2019.05.019subject
Has Abstractpub_date
2020-02-01 00:00:00pages
339-354issue
2eissn
0025-6196issn
1942-5546pii
S0025-6196(19)30486-0journal_volume
95pub_type
杂志文章,评审abstract::Two-dimensional echocardiography is useful for the immediate diagnosis of acute myocardial infarction when diagnostic electrocardiographic changes are absent. The technique is also helpful in distinguishing myocardial infarction from other conditions that may clinically or electrocardiographically mimic infarction. Th...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/s0025-6196(12)61526-2
更新日期:1987-01-01 00:00:00
abstract:OBJECTIVE:To determine the separate effects of exercise intensity and amount on interindividual cardiorespiratory fitness (CRF) response. PARTICIPANTS AND METHODS:Participants were 121 (75 females, 62%) sedentary, middle-aged (mean [SD] age, 53.2 [7.5] years), abdominally obese adults who completed at least 90% of 5 w...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.mayocp.2015.07.024
更新日期:2015-11-01 00:00:00
abstract::A retrospective review of Mayo Clinic records through 1983 revealed 84 patients (24 male and 10 female; mean age, 41 years) with the diagnosis of pulmonary alveolar phospholipoproteinosis. The major clinical features were dyspnea, cough, fever, and chest pain. Chest roentgenograms usually showed bilateral symmetric al...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,评审
doi:10.1016/s0025-6196(12)65477-9
更新日期:1987-06-01 00:00:00
abstract::Health-care organizations have recognized the need to prepare physicians for various leadership and management positions within their own institutions. In the past, those who desired further education had to search beyond the boundaries of their practice to fulfill this need. The demands of a dynamic and changing heal...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/S0025-6196(11)63574-X
更新日期:1997-07-01 00:00:00
abstract::Despite the emergence of clinical ethics consultation as a clinical service in recent years, little is known about how clinical ethics consultation differs from, or is the same as, other medical consultations. A critical assessment of the similarities and differences between these 2 types of consultations is important...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/j.mayocp.2011.10.010
更新日期:2012-04-01 00:00:00
abstract::Lipoproteins are known to be able to transport a variety of drugs. This report suggests that low-density lipoprotein not only functions as an important carrier of cyclosporine in plasma but also facilitates transport of cyclosporine across the cell membrane by means of the low-density lipoprotein receptor. Such a mech...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/s0025-6196(12)64916-7
更新日期:1988-10-01 00:00:00
abstract::Dyspnea is a common symptom that is difficult to define and can result from a wide variety of causes. This complex sensation that arises from multiple stimuli involves both subjective perceptions and objective reactions. In the assessment of patients with dyspnea, use of a systematic approach to determine the precipit...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,评审
doi:10.1016/s0025-6196(12)61344-5
更新日期:1994-07-01 00:00:00
abstract::By identifying structural chromosome anomalies, the clinical cytogenetics laboratory can play a critical role in the diagnosis and treatment of patients with birth defects. Although many new staining techniques have been developed throughout the years to aid in the detection of anomalous chromosomes, some abnormalitie...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/s0025-6196(12)60721-6
更新日期:1992-07-01 00:00:00
abstract::Guidelines for the use of antibiotics in infants and children must take into account drug absorption, distribution, metabolism, and excretion. In the developing human being, these factors may differ significantly from those in the adult, and so there are differences in therapeutic efficacy and toxicity. Certain drugs ...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:
更新日期:1977-11-01 00:00:00
abstract::Breast reconstruction immediately after mastectomy is being used with increasing frequency. In a study of the first 100 consecutive patients at our institution who underwent this procedure, with (21 patients) or without (79 patients) later nipple reconstruction, 85% responded affirmatively on a follow-up questionnaire...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/s0025-6196(12)62440-9
更新日期:1987-03-01 00:00:00
abstract::Patient-centered care requires that treatments respond to the problematic situation of each patient in a manner that makes intellectual, emotional, and practical sense, an achievement that requires shared decision making (SDM). To implement SDM in practice, tools-sometimes called conversation aids or decision aids-are...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,评审
doi:10.1016/j.mayocp.2018.08.030
更新日期:2019-04-01 00:00:00
abstract::In a group of 47 patients with mediastinal granulomas, the most common clinical symptoms were cough, chest pain, dysphagia, hemoptysis, and dyspnea. The main laboratory findings were right paratracheal or hilar mass on chest roentgenogram, positive histoplasmin skin test, and caseating granuloma on histopathologic exa...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:
更新日期:1975-12-01 00:00:00
abstract:OBJECTIVE:To examine whether the outcome of patients with primary systemic amyloidosis (AL) has improved over time and to identify predictors of early mortality in patients with AL. PATIENTS AND METHODS:We studied 2 separate cohorts of patients. The first cohort, consisting of 1998 patients with AL seen at Mayo Clinic...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.4065/mcp.2010.0480
更新日期:2011-01-01 00:00:00
abstract:OBJECTIVE:To analyze the relationship of ideal cardiovascular health to disease-specific death. PATIENTS AND METHODS:We used data from the Aerobics Center Longitudinal Study from October 9, 1987, to March 3, 1999, to estimate the prevalence of ideal cardiovascular health in 11,993 individuals (24.3% women) and to exam...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/j.mayocp.2012.07.015
更新日期:2012-10-01 00:00:00
abstract:OBJECTIVE:To assess the frequency and significance of GB virus-C infection in type 1 autoimmune hepatitis. MATERIAL AND METHODS:Serum specimens from 94 patients with type 1 autoimmune hepatitis were tested for GB virus-C RNA by reverse transcription and polymerase chain reaction. Serum samples from 50 normal subjects ...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/S0025-6196(11)63722-1
更新日期:1998-05-01 00:00:00
abstract:OBJECTIVE:To characterize the findings associated with acute febrile neutrophilic dermatosis (Sweet's syndrome [SS]) and the response of SS to treatment. DESIGN:We retrospectively reviewed 48 cases of SS encountered at the Mayo Clinic between 1980 and 1992. MATERIAL AND METHODS:Histopathologic specimens and medical r...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.4065/70.3.234
更新日期:1995-03-01 00:00:00
abstract:OBJECTIVE:To evaluate the treatment strategies for primary and secondary management of malignancy-related pericardial effusions. PATIENTS AND METHODS:Retrospective review of Mayo Clinic Rochester charts and external records of patients with pericardial effusion associated with malignant disease who required treatment ...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.4065/75.3.248
更新日期:2000-03-01 00:00:00
abstract::Carcinoid tumor of the thymus is a rare neoplasm. Formerly confused with thymoma, a tumor of thymic epithelial cells, carcinoid tumor of the thymus has recently been shown to arise from cells of neuroendocrine origin that are normally present in the thymus. About half of the tumors are either functionally active (usua...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:
更新日期:1980-04-01 00:00:00
abstract::The literature was reviewed to quantify the risk of complications related to the relief of obstruction in urinary retention. We also sought to determine whether the risk of complications is higher with rapid or gradual decompression (or "clamping") of the obstructed urinary bladder. The medical literature was identifi...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,评审
doi:10.1016/S0025-6196(11)63368-5
更新日期:1997-10-01 00:00:00
abstract::During the period November 1979 to October 1984, 19 patients at our institution underwent balloon angioplasty of partial or complete obstruction of aortocoronary artery saphenous vein bypass grafts. The procedures were performed a mean of 38 months after a coronary bypass operation to relieve recurrent angina of at le...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/s0025-6196(12)61392-5
更新日期:1986-01-01 00:00:00
abstract::The detection of monoclonal light chains in the urine by the Bence Jones heat test is a useful adjuvant to the diagnosis of myeloma and other related diseases. The test is particularly helpful when no serum spike is noted. Overall, it is positive in approximately half of all patients with myeloma. In order to assess t...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:
更新日期:1975-05-01 00:00:00
abstract::Currently, computer-assisted imaging can visualize very fast or very slow nonvisible motion events. We can create measurable geometric representations of physiology, including transformation, blood flow velocity, perfusion, pressure, contractility, image features, electricity, metabolism, and a vast number of other co...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,评审
doi:10.4065/74.4.399
更新日期:1999-04-01 00:00:00
abstract:OBJECTIVE:To assess whether patients with pancreatic cancer-associated pain living near a pain control center were more likely to undergo neurolytic celiac plexus block (NCPB) than those living at a distance and to determine the rationale of physicians at our institution for referring patients for NCPB. DESIGN:We retr...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.4065/72.9.831
更新日期:1997-09-01 00:00:00
abstract:OBJECTIVE:To determine the clinical characteristics of hospitalized patients who died of pulmonary embolism, confirmed by evaluative autopsy. DESIGN:We retrospectively analyzed a series of autopsy cases of pulmonary embolism at a tertiary-care center for the period Jan. 1, 1985, through Dec. 31, 1989. MATERIAL AND ME...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.4065/70.5.417
更新日期:1995-05-01 00:00:00
abstract:OBJECTIVE:To investigate the predictors of monoclonal gammopathy of undetermined significance (MGUS) by considering not only the initial features but also the pattern of evolution of the M protein during the first years after diagnosis. PATIENTS AND METHODS:This study consisted of 359 patients diagnosed as having MGUS...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.4065/82.4.428
更新日期:2007-04-01 00:00:00
abstract:OBJECTIVE:To test the hypothesis that chromosomal rearrangements (CRs) can distinguish low risk of progression (LRP) from intermediate and high risk of progression (IHRP) to prostate cancer (PCa) and if these CRs have the potential to identify men with LRP on needle biopsy that harbor IHRP PCa in the prostate gland. P...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/j.mayocp.2018.06.028
更新日期:2019-01-01 00:00:00
abstract::Arterial calcification in the coronary arteries frequently indicates concomitant atherosclerotic plaque but can be present in the medial layers with no evidence of plaque. Calcification of the medial layer of arteries is seen most often in the peripheral arteries but also is widely recognized In the coronary arteries....
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/S0025-6196(11)61536-X
更新日期:2005-06-01 00:00:00
abstract::Three case reports in this article illustrate the diagnostic methods used and the treatment course encountered for many patients with diabetic peripheral neuropathic pain (DPNP). Each case addresses an aspect of DPNP: pain that appears to be refractory to initial therapy, DPNP occurring with other medical conditions, ...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/s0025-6196(11)61476-6
更新日期:2006-04-01 00:00:00
abstract:OBJECTIVE:To estimate the magnitude of association between intraoperative hyperglycemia and perioperative outcomes in patients who underwent cardiac surgery. PATIENTS AND METHODS:We conducted a retrospective observational study of consecutive adult patients who underwent cardiac surgery between June 10, 2002, and Augu...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.4065/80.7.862
更新日期:2005-07-01 00:00:00
abstract::To identify the wishes of patients with amyotrophic lateral sclerosis (ALS) for information, participation in decision making, and life-sustaining therapy and to determine whether these wishes are stable over time, we conducted a prospective survey (baseline and 6-month follow-up interviews) of 38 consecutive patients...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/s0025-6196(12)61577-8
更新日期:1991-09-01 00:00:00