Year: 2019
Type: review
Abstract: There have been significant recent advances in our understanding of the mechanisms that maintain potassium homoeostasis and the clinical consequences of hyperkalemia. In this article we discuss these advances within a concise review of the pathophysiology, risk factors and consequences of hyperkalemia. We highlight aspects that are of particular relevance for clinical practice. Hyperkalemia occurs when renal potassium excretion is limited by reductions in glomerular filtration rate, tubular flow, distal sodium delivery or the expression of aldosterone-sensitive ion transporters in the distal nephron. Accordingly, the major risk factors for hyperkalemia are renal failure, diabetes mellitus, adrenal disease and the use of angiotensin-converting enzyme inhibitors, angiotensin receptor blockers or potassium-sparing diuretics. Hyperkalemia is associated with an increased risk of death, and this is only in part explicable by hyperkalemia-induced cardiac arrhythmia. In addition to its well-established effects on cardiac excitability, hyperkalemia could also contribute to peripheral neuropathy and cause renal tubular acidosis. Hyperkalemia-or the fear of hyperkalemia-contributes to the underprescription of potentially beneficial medications, particularly in heart failure. The newer potassium binders could play a role in attempts to minimize reduced prescribing of renin-angiotensin inhibitors and mineraolocorticoid antagonists in this context.
DOI: 10.1093/ndt/gfz206
Authors: Robert W Hunter, Matthew A Bailey
Language: English
Subfield: Nephrology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $3,926
Awards: Message in a bottle: signalling from glomerulus to renal tubule via RNA in extracellular vesicles, G2705505219, Connecting salt appetite to hypertension in mice with central nervous system deletion of 11β hydroxysteroid dehydrogenase type 2, G430556591, G4987560894, 2nd intake 2018 – PhD Studentship Ms Souzana Angel; Mr Georgios Krilis; McKay; Mr Ben McNeill, Purinergic Regulation of Diabetic Kidney Disease, Does activation of the endothelin system promote the transition of acute kidney injury to chronic kidney disease?
OpenAlex ID: W2993665959