- MeSH
- draslík * fyziologie krev metabolismus MeSH
- lidé MeSH
- nedostatek draslíku etiologie komplikace MeSH
- sodíko-draslíková ATPasa MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- přehledy MeSH
Point-of-care systems based on microchip capillary electrophoresis require single-use, disposable microchips prefilled with all necessary solutions so an untrained operator only needs to apply the sample and perform the analysis. While microchip fabrication can be (and has been) standardized, some manufacturing differences between microchips are unavoidable. To improve analyte precision without increasing device costs or introducing additional error sources, we recently proposed the use of integrated internal standards (ISTDs): ions added to the BGE in small concentrations which form system peaks in the electropherogram that can be used as a measurement reference. Here, we further expand this initial proof-of-principle test to study a clinically-relevant application of K ion concentrations in human blood; however, using a mock blood solution instead of real samples to avoid interference from other obstacles (e.g. cell lysis). Cs as an integrated ISTD improves repeatability of K ion migration times from 6.97% to 0.89% and the linear calibration correlation coefficient (R2 ) for K quantification from 0.851 to 0.967. Peak area repeatability improves from 11.6-13.3% to 4.75-5.04% at each K concentration above the LOQ. These results further validate the feasibility of using integrated ISTDs to improve imprecision in disposable microchip CE devices by demonstrating their application for physiological samples.
Souhrnný článek se zabývá rozdíly mezi antihypertenzivy, která mají vliv na koncentraci draslíku. Je probrán rozdíl mezi inhibitory angiotenzin konvertujícího enzymu (angiotensin converting enzyme, ACE) a sartany a rozdíl mezi thiazidovými a podobnými (thiazide-like) diuretiky. Zejména je diskutováno ovlivnění koncentrace draslíku užíváním indapamidu. Na závěr je zmíněno, že hypokalemie může mít i celou řadu jiných příčin než jen užívání diuretik.
This review describes differences between antihypertensive drugs which influence potassium levels. Difference between ACE inhibitors and sartans and between thiazide and thiazide-like diuretics is being discussed. Especially the influence of indapamide on potassium level is explained. At the end other reasons of hypokalemia than just using of diuretics are mentioned.
- MeSH
- antihypertenziva * škodlivé účinky MeSH
- blokátory receptoru 1 pro angiotenzin II aplikace a dávkování MeSH
- diuretika aplikace a dávkování farmakologie škodlivé účinky MeSH
- draslík krev MeSH
- fixní kombinace léků MeSH
- hypokalemie * etiologie metabolismus MeSH
- indapamid farmakologie MeSH
- inhibitory ACE farmakologie MeSH
- vztah mezi dávkou a účinkem léčiva MeSH
- MeSH
- chronická lymfatická leukemie komplikace patologie MeSH
- draslík krev MeSH
- hyperkalemie diagnóza etiologie patologie MeSH
- lidé MeSH
- senioři MeSH
- stupeň závažnosti nemoci MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
- práce podpořená grantem MeSH
BACKGROUND: The interaction between chronic medications on admission and the association between serum potassium level and outcome in patients with acute heart failure (AHF) are unknown. METHODS: Observational intercontinental study of patients admitted with AHF. 15954 patients were included from 12 cohorts in 4 continents. Main outcome was 90-day mortality. Clinical presentation (medication use, hemodynamics, comorbidities), demographic, echocardiographic, and biochemical data on admission were recorded prospectively in each cohort, with prospective adjudication of outcomes. RESULTS: Positive and negative linear relationships between 90-day mortality and sK+ above 4.5 mmol/L (hyperkalemia) and below 3.5 mmol/L (hypo-kalemia) were observed. Hazard ratio for death was 1.46 [1.34-1.58] for hyperkalemia and 1.22 [1.06-1.40] for hypokalemia. In a fully adjusted model, only hyperkalemia remained associated with mortality (HR 1.03 [1.02-1.04] for each 0.1 mmol/l change of sK+ above 4.5 mmol/L). Interaction tests revealed that the association between hyperkalemia and outcome was significantly affected by chronic medications. The association between hyperkalemia and mortality was absent for patients treated with beta blockers and in those with preserved renal function. CONCLUSIONS: In patients with AHF, sK+ > 4.5 mmol/L appears to be associated with 90-day mortality. B-blockers have potentially a protective effect in the setting of hyperkalemia.
- MeSH
- akutní nemoc MeSH
- beta blokátory terapeutické užití MeSH
- biologické markery krev MeSH
- časové faktory MeSH
- draslík krev MeSH
- hyperkalemie etiologie mortalita prevence a kontrola MeSH
- hypokalemie etiologie mortalita prevence a kontrola MeSH
- lidé středního věku MeSH
- lidé MeSH
- míra přežití trendy MeSH
- následné studie MeSH
- prospektivní studie MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- srdeční selhání krev komplikace farmakoterapie MeSH
- výsledek terapie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
- pozorovací studie MeSH
- Geografické názvy
- Evropa epidemiologie MeSH
- Spojené státy americké epidemiologie MeSH
- MeSH
- chronické selhání ledvin komplikace krev mortalita MeSH
- dialýza ledvin * MeSH
- draslík * analýza krev MeSH
- hemodialyzační roztoky * chemie MeSH
- hodnocení rizik MeSH
- hodnocení výsledků zdravotní péče MeSH
- lidé MeSH
- prospektivní studie MeSH
- srdeční arytmie etiologie mortalita MeSH
- Check Tag
- lidé MeSH
Hyperkalemia is a potentially lethal condition. Pseudohyperkalemia should be always excluded before implementing treatment to prevent inappropriate cause of hypokalemia - equally a potentially lethal condition. Here we present a case report of a 62 year female with chronic myeloproliferative disorder, i.e. essential thrombocythemia. The laboratory test results for potassium concentration were 6.3 mmol/L, for platelet count 1305 x109/L and for leukocyte count 39.8 x109/L. This was due to a temporary drug withdrawal after a surgical intervention for gastric bleeding. Potassium concentration in lithium heparin plasma collected in a vacuum tube without gel separator and in whole blood syringe were 4.6 mmol/L and 3.4 mmol/L, respectively. It means that mechanical stress such as centrifugation can contribute to spurious hyperkalemia. Prior to reporting unexpected hyperkalemia result, pseudohyperkalemia should always be considered by the laboratory. Such potassium results require investigation in case it is pseudohyperkalemia, which may be due to thrombocytosis and leukocytosis. In cases where thrombocytosis or leukocytosis exists, an interpretative comment indicating these conditions inserted with the results of the potassium concentration can increase awareness for more accurate patient care decisions.
- MeSH
- biochemická analýza krve metody MeSH
- centrifugace MeSH
- diferenciální diagnóza MeSH
- draslík krev MeSH
- hemokoagulace MeSH
- hyperkalemie diagnóza MeSH
- Janus kinasa 2 genetika MeSH
- leukocyty cytologie metabolismus MeSH
- lidé středního věku MeSH
- lidé MeSH
- myeloproliferativní poruchy genetika patologie MeSH
- trombocyty cytologie metabolismus MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
Primary aldosteronism (PA) is associated with objectively measured lower physical fitness and blunted response of the renin-angiotensin-aldosterone system to exercise. The purpose of this pilot study was to objectively measure exercise response of the renin-angiotensin-aldosterone system and cardiopulmonary fitness changes after laparoscopic adrenalectomy (ADE) in patients with unilateral PA. We examined a total of 14 patients with confirmed PA before and after ADE, by means of spiroergometry and hormonal evaluation. As expected, after adrenalectomy basal aldosterone (Aldo) levels before exercise decreased significantly, with a concomitant increase in plasma renin (PR). The increase in Aldo (285.9+/-171.3 to 434.1+/-278.2 ng/l; p=0.02) and blunted increase in PR (7.1+/-0.4 to 8.9+/-10.4 pg/ml; NS) post-exercise before ADE became significant after ADE Aldo post-ADE (46.8+/-18.8 to 106.5+/-68.1 ng/l; p<0.0001) and PR post-ADE (20.1+/-14.5 to 33.9+/-30.7 pg/ml; p=0.014). After adrenalectomy, the patients had a non-significant increase in peak workload and VO(2peak). We found normalization of the renin-angiotensin-aldosterone system response to exercise with little changes in cardiopulmonary fitness six months after ADE.
- MeSH
- adrenalektomie * MeSH
- aldosteron MeSH
- ambulantní monitorování krevního tlaku MeSH
- anaerobní práh MeSH
- dospělí MeSH
- draslík krev MeSH
- hormony krev MeSH
- hyperaldosteronismus patofyziologie chirurgie MeSH
- lidé středního věku MeSH
- lidé MeSH
- pilotní projekty MeSH
- renin-angiotensin systém * MeSH
- tělesná výkonnost MeSH
- tolerance zátěže * MeSH
- výsledek terapie MeSH
- zátěžový test MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- MeSH
- chronická renální insuficience farmakoterapie MeSH
- draslík krev MeSH
- hyperkalemie * farmakoterapie prevence a kontrola MeSH
- kationtoměniče terapeutické užití MeSH
- lidé MeSH
- polymery škodlivé účinky terapeutické užití MeSH
- polystyreny terapeutické užití MeSH
- silikáty * škodlivé účinky terapeutické užití MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- přehledy MeSH
