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    "textoCompleto" => "To the editor&#58; Intravenous calcium is used in the treatment of severe hyperkalemia with cardiac impact because it <br></br>antagonizes the action of potassium on the cell membrane&#44; although it does not reduce the serum potassium level&#46; In general&#44; it is used in intermittent doses for 30-60 minutes and it buys time until other conservative measures take effect or until haemodialysis is available&#46; We describe a patient with severe hyperkalemia treated with a continuous infusion of calcium gluconate&#46; <br></br><br></br>A 79-year-old woman came in due to reduced dieresis and lower extremity weakness&#46; Five days prior to arrival&#44; a <br></br>cardiac catheterisation has been made with placement of 2 stents&#46; The medical history included&#58; ischemic heart disease with 3 myocardial infarctions&#44; dyspnea on minimum effort&#44; diabetes mellitus&#44; chronic renal failure &#40;baseline creatinine 1&#46;5-2 mg&#47;dl&#41;&#44; hypertension under treatment with ramipril&#44; obesity and polyarthrosis&#46; Physical examination&#58; BP 130&#47;60 mmHg&#44; afebrile&#44; CA&#58; rhythmic at 60 bpm&#59; PA&#58; rhonchi and isolated crepitants&#44; generalized oedema&#46; Laboratory results&#58; haemoglobin 8&#46;7 g&#47;dl&#44; glucose 173 mg&#47;dl&#44; BUN 249 mg&#47;dl&#44; creatinine 9&#46;31 mg&#47;dl&#44; normal CK and troponin-I&#44; sodium 124 meq&#47;l&#44; potassium 8&#46;89 meq&#47;l&#44; pH 7&#46;3&#44; bicarbonate 17&#46;3 meq&#47;l&#59; following bladder catheterisation&#44; a scant amount of urine was recovered&#44; the analysis of which revealed&#58; SG 1&#46;005&#44; urine protein 30-70 mg&#47;dl&#44; sediment&#58; 4-6 RBC&#47;hpf&#44; leukocyturia&#46; ECG&#58; wide QRS complexes measuring 160-200 milliseconds a 60 bpm and absent P waves&#46; Renal ultrasound&#58; kidneys of normal size without ectasia&#46; Chest x-ray&#58; vascular redistribution&#46; The patient and the family were informed of the severity of the situation and the possible need for dialysis&#46; The family refused haemodialysis and requested conservative treatment that does not cause suffering to space out laboratory testing&#46; The patient was initially administered seguril 250 mg bolus and 20 ml of 10&#37; calcium gluconate over 30 minutes&#46; Later&#44; she was treated with 24-hour continuous infusions of seguril 250 mg&#44; 500 ml of D10W with 10 U of rapid-acting insulin and 250 ml of D5W with 60 ml of 10&#37; calcium gluconate plus oral Resonium &#174;&#46; A day later&#44; dieresis was 500 ml&#44; potassium 8&#46;59 meq&#47;l&#44; total calcium 9&#46;63 mg&#47;dl&#59; the ECG showed narrow QRS complexes&#59; the treatment ordered was continued&#46; Subsequent progress was good with a progressive increase in dieresis and a reduction in creatinine and potassium&#46; After 3 weeks of hospitalisation&#44; the creatinine was 1&#46;72 mg&#47;dl and the potassium was 4 meq&#47;l&#46; <br></br><br></br>Once haemodialysis was ruled out in our patient&#44; we considered different conservative measures for her situation&#46; <br></br>Hypertonic glucose with insulin temporarily reduces serum potassium by facilitating cell uptake&#46; There are different <br></br>guidelines&#44; but hypoglycaemia is not uncommon&#44; which is why infusion of hypertonic glucose solution at a variable <br></br>rate &#40;50-75 ml&#47;h&#41;1-3 is recommended after initial treatment&#44; a method that could have exacerbated the patient&#191;s <br></br>hypervolaemia&#46; Sodium bicarbonate can also cause volume overload and its use is also controversial&#46;1&#44;2&#160; &#946;2-antagonists can produce tachyarrhythmia and lead to myocardial ischemia at the dosages needed to reduce potassium&#46;1 In this patient with a significant history of ischemic heart disease&#44; hypervolaemia and anuria&#44; we considered to be less of a risk to use continuous infusion of calcium and wait for restoration of dieresis&#46; <br></br><br></br>Intravenous calcium antagonises the effects of hyperkalaemia on the heart&#59; on the one hand&#44; it reduces threshold <br></br>potential electronegativity&#44; restores the difference between the membrane and reduces myocyte excitability&#59; on the <br></br>other hand&#44; it increases the maximum velocity of the action potential and improves cardiac conduction&#46;4 It has been <br></br>suggested that continuous calcium infusion will lead to more stable levels and better results than intermittent dosages&#46;5 <br></br><br></br>In summary&#44; continuous calcium infusion is a therapeutic option that may offer advantages over other conservative <br></br>treatment measures in extreme patients with severe hyperkalaemia&#46; "
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                  "referenciaCompleta" => "1, Salem MM, Rosa RM, Batlle DC. Extrarenal potassium tolerance in chronic renal failure: implications for the treatment of acute hyperkalemia. Am J Kidney Dis 18: 421-440, 1991. <a href="http://www.ncbi.nlm.nih.gov/pubmed/1928061" target="_blank">[Pubmed]</a>"
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                0 => array:3 [
                  "referenciaCompleta" => "Allon M. Treatment and prevention of hyperkalemia in end-stage renal disease. Kidney Int 43: 1197-1209, 1993. <a href="http://www.ncbi.nlm.nih.gov/pubmed/8315933" target="_blank">[Pubmed]</a>"
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                0 => array:3 [
                  "referenciaCompleta" => "Emmett M. Non-dialytic treatment of acute hyperkalemia in the dialysis patient. Semin Dial 13: 279-280, 2000. <a href="http://www.ncbi.nlm.nih.gov/pubmed/11014688" target="_blank">[Pubmed]</a>"
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                0 => array:3 [
                  "referenciaCompleta" => "Parham WA, Mehdirad AA, Biermann KM, Fredman CS. Hyperkalemia revisited. Tex Heart Inst J 33: 40-47, 2006. <a href="http://www.ncbi.nlm.nih.gov/pubmed/16572868" target="_blank">[Pubmed]</a>"
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                0 => array:3 [
                  "referenciaCompleta" => "de Takats D. Using calcium salts for hyperkalaemia. Nephrol Dial Transplant 19: 1333-1334, 2004. <a href="http://www.ncbi.nlm.nih.gov/pubmed/15102983" target="_blank">[Pubmed]</a>"
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Persistent severe hyperkalemia treated with a continuous infusion of calcium gluconate
Tratamiento de la hiperpotasemia severa mantenida con perfusión continua de gluconato cálcico
ANA ESTHER SIRVENTa, RICARDO ENRÍQUEZa, CÉSAR GONZÁLEZa, ADOLFO REYESa
a SECCIÓN DE NEFROLOGÍA, HOSPITAL DE ELCHE ELCHE ALICANTE, ESPAÑA,
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    "textoCompleto" => "To the editor&#58; Intravenous calcium is used in the treatment of severe hyperkalemia with cardiac impact because it <br></br>antagonizes the action of potassium on the cell membrane&#44; although it does not reduce the serum potassium level&#46; In general&#44; it is used in intermittent doses for 30-60 minutes and it buys time until other conservative measures take effect or until haemodialysis is available&#46; We describe a patient with severe hyperkalemia treated with a continuous infusion of calcium gluconate&#46; <br></br><br></br>A 79-year-old woman came in due to reduced dieresis and lower extremity weakness&#46; Five days prior to arrival&#44; a <br></br>cardiac catheterisation has been made with placement of 2 stents&#46; The medical history included&#58; ischemic heart disease with 3 myocardial infarctions&#44; dyspnea on minimum effort&#44; diabetes mellitus&#44; chronic renal failure &#40;baseline creatinine 1&#46;5-2 mg&#47;dl&#41;&#44; hypertension under treatment with ramipril&#44; obesity and polyarthrosis&#46; Physical examination&#58; BP 130&#47;60 mmHg&#44; afebrile&#44; CA&#58; rhythmic at 60 bpm&#59; PA&#58; rhonchi and isolated crepitants&#44; generalized oedema&#46; Laboratory results&#58; haemoglobin 8&#46;7 g&#47;dl&#44; glucose 173 mg&#47;dl&#44; BUN 249 mg&#47;dl&#44; creatinine 9&#46;31 mg&#47;dl&#44; normal CK and troponin-I&#44; sodium 124 meq&#47;l&#44; potassium 8&#46;89 meq&#47;l&#44; pH 7&#46;3&#44; bicarbonate 17&#46;3 meq&#47;l&#59; following bladder catheterisation&#44; a scant amount of urine was recovered&#44; the analysis of which revealed&#58; SG 1&#46;005&#44; urine protein 30-70 mg&#47;dl&#44; sediment&#58; 4-6 RBC&#47;hpf&#44; leukocyturia&#46; ECG&#58; wide QRS complexes measuring 160-200 milliseconds a 60 bpm and absent P waves&#46; Renal ultrasound&#58; kidneys of normal size without ectasia&#46; Chest x-ray&#58; vascular redistribution&#46; The patient and the family were informed of the severity of the situation and the possible need for dialysis&#46; The family refused haemodialysis and requested conservative treatment that does not cause suffering to space out laboratory testing&#46; The patient was initially administered seguril 250 mg bolus and 20 ml of 10&#37; calcium gluconate over 30 minutes&#46; Later&#44; she was treated with 24-hour continuous infusions of seguril 250 mg&#44; 500 ml of D10W with 10 U of rapid-acting insulin and 250 ml of D5W with 60 ml of 10&#37; calcium gluconate plus oral Resonium &#174;&#46; A day later&#44; dieresis was 500 ml&#44; potassium 8&#46;59 meq&#47;l&#44; total calcium 9&#46;63 mg&#47;dl&#59; the ECG showed narrow QRS complexes&#59; the treatment ordered was continued&#46; Subsequent progress was good with a progressive increase in dieresis and a reduction in creatinine and potassium&#46; After 3 weeks of hospitalisation&#44; the creatinine was 1&#46;72 mg&#47;dl and the potassium was 4 meq&#47;l&#46; <br></br><br></br>Once haemodialysis was ruled out in our patient&#44; we considered different conservative measures for her situation&#46; <br></br>Hypertonic glucose with insulin temporarily reduces serum potassium by facilitating cell uptake&#46; There are different <br></br>guidelines&#44; but hypoglycaemia is not uncommon&#44; which is why infusion of hypertonic glucose solution at a variable <br></br>rate &#40;50-75 ml&#47;h&#41;1-3 is recommended after initial treatment&#44; a method that could have exacerbated the patient&#191;s <br></br>hypervolaemia&#46; Sodium bicarbonate can also cause volume overload and its use is also controversial&#46;1&#44;2&#160; &#946;2-antagonists can produce tachyarrhythmia and lead to myocardial ischemia at the dosages needed to reduce potassium&#46;1 In this patient with a significant history of ischemic heart disease&#44; hypervolaemia and anuria&#44; we considered to be less of a risk to use continuous infusion of calcium and wait for restoration of dieresis&#46; <br></br><br></br>Intravenous calcium antagonises the effects of hyperkalaemia on the heart&#59; on the one hand&#44; it reduces threshold <br></br>potential electronegativity&#44; restores the difference between the membrane and reduces myocyte excitability&#59; on the <br></br>other hand&#44; it increases the maximum velocity of the action potential and improves cardiac conduction&#46;4 It has been <br></br>suggested that continuous calcium infusion will lead to more stable levels and better results than intermittent dosages&#46;5 <br></br><br></br>In summary&#44; continuous calcium infusion is a therapeutic option that may offer advantages over other conservative <br></br>treatment measures in extreme patients with severe hyperkalaemia&#46; "
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