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Tailoring treatment of hyperkalemia.
Nephrol Dial Transplant 2019; 34(Supplement_3):iii62-iii68ND

Abstract

Hyperkalemia is a common electrolyte disorder that may be rapidly life-threatening because of its cardiac toxicity. Hyperkalemia risk factors are numerous and often combined in the same patient. Most of the strategies to control serum potassium level in the short term have been used for decades. However, evidence for their efficacy and safety remains low. Treatment of hyperkalemia remains challenging, poorly codified, with a risk of overtreatment, including short-term side effects, and with the priority of avoiding unnecessary hospital stays or chronic medication changes. Recently, new oral treatments have been proposed for non-life-threatening hyperkalemia, with encouraging results. Their role in the therapeutic arsenal remains uncertain. Finally, a growing body of evidence suggests that hyperkalemia might negatively impact outcomes in the long term in patients with chronic heart failure or kidney failure through underdosing or withholding of cardiovascular medication (e.g. renin-angiotensin-aldosterone system inhibitors). Recognition of efficacy and potential side effects of treatment may help in tailoring treatments to the patient's status and conditions. In this review we discuss how treatment of hyperkalemia could be tailored to the patient's conditions and status, both on the short and mid term.

Authors+Show Affiliations

Department of Anesthesiology and Critical Care and Burn Unit, Saint-Louis Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France. INSERM UMR-S942, Institut National de la Santé et de la Recherche Médicale, Lariboisiére Hospital, Paris, France. University of Paris, Paris Diderot, France.Department of Anesthesiology and Critical Care and Burn Unit, Saint-Louis Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France. INSERM UMR-S942, Institut National de la Santé et de la Recherche Médicale, Lariboisiére Hospital, Paris, France. University of Paris, Paris Diderot, France.INSERM UMR-S942, Institut National de la Santé et de la Recherche Médicale, Lariboisiére Hospital, Paris, France. University of Paris, Paris Diderot, France. Department of Anesthesiology and Peri-Operative Care, University of California, San Francisco, San Francisco, CA, USA. INI-CRCT Network, Nancy, France.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31800081

Citation

Coutrot, Maxime, et al. "Tailoring Treatment of Hyperkalemia." Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association, vol. 34, no. Supplement_3, 2019, pp. iii62-iii68.
Coutrot M, Dépret F, Legrand M. Tailoring treatment of hyperkalemia. Nephrol Dial Transplant. 2019;34(Supplement_3):iii62-iii68.
Coutrot, M., Dépret, F., & Legrand, M. (2019). Tailoring treatment of hyperkalemia. Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association, 34(Supplement_3), pp. iii62-iii68. doi:10.1093/ndt/gfz220.
Coutrot M, Dépret F, Legrand M. Tailoring Treatment of Hyperkalemia. Nephrol Dial Transplant. 2019 Dec 1;34(Supplement_3):iii62-iii68. PubMed PMID: 31800081.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Tailoring treatment of hyperkalemia. AU - Coutrot,Maxime, AU - Dépret,Francois, AU - Legrand,Matthieu, PY - 2019/06/06/received PY - 2019/12/5/entrez PY - 2019/12/5/pubmed PY - 2019/12/5/medline KW - chronic kidney disease KW - hyperkalemia KW - renin–angiotensin–aldosterone system inhibitor SP - iii62 EP - iii68 JF - Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association JO - Nephrol. Dial. Transplant. VL - 34 IS - Supplement_3 N2 - Hyperkalemia is a common electrolyte disorder that may be rapidly life-threatening because of its cardiac toxicity. Hyperkalemia risk factors are numerous and often combined in the same patient. Most of the strategies to control serum potassium level in the short term have been used for decades. However, evidence for their efficacy and safety remains low. Treatment of hyperkalemia remains challenging, poorly codified, with a risk of overtreatment, including short-term side effects, and with the priority of avoiding unnecessary hospital stays or chronic medication changes. Recently, new oral treatments have been proposed for non-life-threatening hyperkalemia, with encouraging results. Their role in the therapeutic arsenal remains uncertain. Finally, a growing body of evidence suggests that hyperkalemia might negatively impact outcomes in the long term in patients with chronic heart failure or kidney failure through underdosing or withholding of cardiovascular medication (e.g. renin-angiotensin-aldosterone system inhibitors). Recognition of efficacy and potential side effects of treatment may help in tailoring treatments to the patient's status and conditions. In this review we discuss how treatment of hyperkalemia could be tailored to the patient's conditions and status, both on the short and mid term. SN - 1460-2385 UR - https://www.unboundmedicine.com/medline/citation/31800081/Tailoring_treatment_of_hyperkalemia L2 - https://academic.oup.com/ndt/article-lookup/doi/10.1093/ndt/gfz220 DB - PRIME DP - Unbound Medicine ER -