• acute neuromuscular paralysis
• betamethasone
• case report
• hypokalemia
• seasonal allergic rhinitis
• severe adverse reaction

• Acidosis
• Alkalosis
• Anion gap
• Chloride-sensitive
• Ketoacidosis
• MUDPILES
• Metabolic

• Humans
• Acid-Base Imbalance/diagnosis
• Acid-Base Imbalance/therapy
• Acid-Base Imbalance/etiology
• Acidosis/diagnosis
• Acidosis/therapy
• Acidosis/etiology
• Alkalosis/complications
• Alkalosis/therapy

• emergency department
• mild hypokalemia
• mortality
• potassium
• propensity score

• Humans
• Male
• Middle Aged
• Female
• Potassium
• Hypokalemia
• Hospital Mortality
• Retrospective Studies
• Propensity Score
• Emergency Service, Hospital

• UL1 TR001860 NCATS NIH HHS

• Nomogram
• Oral cancer
• Platelet-to-lymphocyte ratio
• Postoperative complication
• Postoperative hypokalemia

• Humans
• Female
• Retrospective Studies
• Hypokalemia/etiology
• Mouth Neoplasms/surgery
• Risk Factors
• Potassium

• Young Clinical Research Fund of the Chinese Academy of Stomatology

• Humans
• Renin-Angiotensin System
• Hyperkalemia/chemically induced
• Hyperkalemia/drug therapy
• Angiotensin Receptor Antagonists/adverse effects
• Angiotensin-Converting Enzyme Inhibitors/adverse effects
• Renal Insufficiency, Chronic/therapy
• Acute Kidney Injury/chemically induced
• Acute Kidney Injury/drug therapy

Hypokalemia is a common form of electrolyte disorder, which has a higher incidence in hospitalized patients and is closely related to perioperative complications and prognosis. Due to decreased skeletal muscle mass which causes total body potassium reduction, and increased comorbidities, the elderly are more susceptible to hypokalemia.

To investigate preoperative hypokalemia in elderly patients and its effect on postoperative complications.

Data were retrospectively collected from the elderly patients who underwent elective surgery from April 2018 to March 2019 and had preoperative blood gas data available. Patients, with age 60 to 100 years, were divided into hypokalemia group (potassium level < 3.5 mmol/L) and normokalemia group (potassium level between 3.5 and 5.5 mmol/L) according to preoperative blood gas analysis. Hypokalemia can be divided into mild (potassium level 3.0 to 3.5 mmol/L), moderate (potassium level 2.5 to 3.0 mmol/L) and severe (potassium level < 2.5 mmol/L), respectively. The risk factors of preoperative hypokalemia and its impact on postoperative complications and prognosis were primary outcomes. Secondary outcomes included postanesthesia care unit (PACU) stay time and hospital length of stay (LOS).

Of 987 participants, 436 (44.17%) developed preoperative hypokalemia, among them 357 (81.88%) mild, 87 (16.74%) moderate and 6 (1.38%) severe. Multivariate logistic regression showed that female gender (OR, 1.851; 95% CI, 1.415–2.421), pre-existing hypokalemia at admission (OR, 4.498; 95% CI, 2.506–8.071), and oral laxative twice or more (OR, 1.823; 95% CI, 1.266–2.624) are risk factors of preoperative hypokalemia. Gynecological and biliopancreatic surgery were more common in hypokalemia group than normokalemia group (P <  0.001, P <  0.05). There was no significant difference in postoperative complications, PACU stay time, LOS, and 30-day mortality between the two groups (all P >  0.05).

Female gender, pre-existing hypokalemia at admission, and oral laxative twice or more are independent risk factors for preoperative hypokalemia in elderly patients. However, postoperative complications and 30-day mortality were not increased, which may be related to monitoring blood gas analysis and prompt correction of potassium levels during surgery.

The online version contains supplementary material available at 10.1186/s12877-022-03445-1.

• Complication
• Hypokalemia
• Risk factors
• The elderly

• K2P1 channel
• cardiac arrhythmia
• hypokalemia
• ventricular ectopic beat

• Gitelman syndrome
• Hyperkaliuria
• Hypermagnesiuria
• Inherited tubulopathy

• Child
• Female
• Gitelman Syndrome
• Humans
• Hypokalemia/diagnosis
• Hypokalemia/etiology
• Magnesium

• arterial hypertension
• calcineurin inhibitor
• hydrochlorothiazide
• pediatric liver transplantation
• sodium chloride cotransporter

• cardiovascular risk biomarkers
• cross-sectional
• health-related biomarkers
• intermittent fasting
• older adults
• time-restricted feeding

A 10‐year‐old 466 kg mustang gelding presented to an equine referral hospital for surgical repair of nasal, frontal and lacrimal bone fractures from an unknown trauma. Surgical repair was performed under general anaesthesia, including a right‐sided maxillary regional anaesthetic block with mepivacaine hydrochloride. Progressive hyperkalaemia was documented perianaesthetically (T‐3 mins; 134 mins after induction; potassium 6.4 mmol/L (ref 3.5‐5.1 mmol/L). Perianaesthetic bradycardia was attributed to alpha −2 agonist infusion administration, and other characteristic ECG changes (flattened P waves, narrow T waves of increased amplitude, prolonged QRS complex) were not documented. Asystole occurred 137 min after induction of anaesthesia; however, a review of the available literature suggests the degree of hyperkalaemia documented was unlikely to be the primary cause of asystole but may have been a contributing factor. It is hypothesised that a trigeminocardiac reflex was the primary contributory factor to asystole in the described case, and may represent a maxillomandibulocardiac reflex that has not been previously described in the horse.

• horse

A novel NIF fluorescent probe, ZM-V, was designed, in which interior imidazole and benzopyrene moieties serve as rotators, which can spin around multiple C–C bonds in the conjugated skeleton.

• Emergency Service, Hospital
• Female
• France/epidemiology
• Humans
• Hyperkalemia/epidemiology
• Incidence
• Male
• Retrospective Studies

This study reports a case of a 13-year-old male with a 3-year history of severe and intermittent hypokalemia episodes of unknown origin, requiring admission to the intensive care unit (ICU) for long QT syndrome (LQTS), finally diagnosed of redistributive hypokalemia secondary to the abuse of β-adrenergic agonists in the context of a probable factitious disorder.

The direct anterior approach (DAA) has gained popularity in total hip arthroplasty (THA) over the past decade. A large number of studies have compared the DAA to other approaches with inclusion of a learning curve phase. The aim of this study was to compare the complication rate and bleeding between the DAA and the anterolateral approach after the learning curve phase.

For this retrospective, single-institutional study, propensity score matching was performed, from an initial cohort of 1408 patients receiving an elective THA. Two matching groups were created, comprising of 396 patients each. After matching, both groups were similar in age, gender, body mass index, anesthesiologist’s score and surgeon’s experience.

Average age in the matched groups was 68.7 ± 10.3 years. The total blood loss was similar in both groups, 450 vs 469 mL (p = 0.400), whereas the transfusion rate (14.1 vs 5.8%, p < 0.001) and the overall complication rate (17.6 vs 12.1%, p = 0.018) were lower in the DAA group. The overall fracture rate was comparable, 1.5 vs 1% (p = 0.376), as well as the early infection rate, 0.3 vs 1% (p = 0.162). The dislocation rate was significantly increased in the DAA group, 2.2 vs 0.5% (p = 0.032).

The direct anterior approach has comparable short-term surgical complications with reduced transfusion and general complication rates.

Level III retrospective study.

• Anterolateral approach
• Bleeding
• Direct anterior approach
• Hip arthroplasty
• Infection

Diabetes affects approximately 30 million persons in the United States. Diabetes ketoacidosis is one of the most serious and acute complications of diabetes. At the time of presentation and during treatment of diabetic ketoacidosis (DKA), several metabolic and electrolyte derangements can ultimately result in respiratory compromise. Most commonly, hypokalemia, hypomagnesemia and hypophosphatemia can eventually lead to respiratory muscles failure. Furthermore, tachypnea, hyperpnea and more severely, Kussmaul breathing pattern can develop. Also, hydrostatic and non-hydrostatic pulmonary edema can occur secondary to volume shifts into the extracellular space and secondary to increased permeability of the pulmonary capillaries. The presence of respiratory failure in patients with DKA is associated with higher morbidity and mortality. Being familiar with the causes of respiratory compromise in DKA, and how to treat them, may represent better outcomes for patients with DKA.

• Diabetes ketoacidosis
• Respiratory physiology
• Mechanical ventilation
• metabolic acidosis
• Hyperventilation
• Kussmaul breathing
• Respiratory failure

• acidosis
• blood gasses
• cardiovascular
• diabetic ketoacidosis
• hypokalemia
• insulin
• pH
• potassium
• treatment outcomes

We experienced a case of severe intraoperative hyperkalemia during laparoscopic radical nephrectomy in a 60-year-old male patient with renal insufficiency, whose hypertension had been managed by preoperative angiotensin II receptor blocker (ARB) and adrenergic beta-antagonist. After renal vessel ligation, his intraoperative potassium concentration suddenly increased to 7.0 mEq/L, but his electrocardiography (ECG) did not show any significant change. While preoperative ARB therapy has been regarded as a contributing factor for further aggravation of underlying renal insufficiency, we assumed that nephrectomy itself and rhabdomyolysis caused by surgical trauma also aggravated the underlying renal dysfunction and resulted in sudden hyperkalemia. Hyperkalemia was managed successfully with calcium gluconate, insulin, furosemide and crystalloid loading during the intraoperative and immediate postoperative periods, and potassium concentration decreased to 5.0 mEq/L at 8 hours after the operation. The patient’s hospital course was uncomplicated, but his renal function deteriorated further.

• cardiovascular diseases
• diabetic ketoacidosis
• hypokalemia
• mortality
• potassium replacement
• treatment outcome

• Arrhythmias
• Diabetes
• Endocrine System
• Neuromuscular Disease

• Hyperkalemia
• Hypokalemia
• Mortality
• Myocardial Infarction
• Potassium

• Abamectin
• Albino rats
• Biochemical parameters
• Eruca sativa
• Hematological parameters

• Animals
• Egypt
• Insecticides/toxicity
• Ivermectin/analogs & derivatives
• Ivermectin/toxicity
• Male
• Oxidative Stress/drug effects
• Rats

Patients with gastrointestinal bleeding often require large volume blood transfusion. Among the various side effects of blood transfusion, the increase of potassium levels is a serious one which is often overlooked. We report a case of severe hyperkalemia in a patient with gastric bleeding after large volume transfusion of packed red blood cells. The patient had hyperkalemia at baseline associated with his receiving medication as well as acute renal failure following hypovolemia. The baseline hyperkalemia was further aggravated after massive transfusions of packed red blood cells in a short period of time. The associated pathogenetic mechanisms resulting in the increase of potassium levels are presented. A number of risk factors which increase the risk of hyperkalemia after blood transfusion are discussed. Moreover, appropriate management strategies for the prevention of blood transfusion associated hyperkalemia are also presented. Physicians should always keep in mind the possibility of hyperkalemia in cases of blood transfusion.

• Hyperkalemia
• Blood transfusions
• Packed red blood cells
• Renal function
• Gastrointestinal bleeding

• Bartter syndrome
• Children
• Gitelman syndrome
• Hypokalaemia
• Steroidogenesis disorders

Context. Pseudohypoaldosteronism type 1 (PHA1) is a life-threatening disease that causes severe hyperkalemia and cardiac arrest if not treated appropriately or if diagnosis is missed. Objective. To report a case of a newborn with vomiting and lethargy, ultimately diagnosed with pseudohypoaldosteronism. Patient. This case presented to the ED at an age of 14 days in hypovolemic shock. There was a family history of sudden infant death, her sister who was diagnosed with CAH and passed away at 3 months of age despite regular hormone replacement. Our patient had cardiac arrest in ED, due to hyperkalemia; while receiving fluid boluses, cardiopulmonary resuscitation was initiated. After stabilization, diagnostic workup demonstrated persistently low sodium, acidosis, and high potassium, which required peritoneal dialysis. Based on these findings, the patient was diagnosed with CAH. It turned out later that the patient had PHA1. Two years later, the patient had a new sibling with the same disease diagnosed at birth and started immediately on treatment without any complication. Conclusions and Outcome. This case highlights the significant diagnostic and therapeutic challenges in treating children with PHA1. Adrenal crisis is not always CAH; delayed diagnosis can lead to complication and even death. The presence of high plasma renin activity, aldosterone, and cortisol, along with the presence of hyponatremia and hyperkalemia, established the diagnosis of PHA type 1 and ruled out CAH.

• Aged
• Aged, 80 and over
• Angiotensin Receptor Antagonists/therapeutic use
• Angiotensin-Converting Enzyme Inhibitors/therapeutic use
• Anti-Infective Agents, Urinary/adverse effects
• Case-Control Studies
• Death, Sudden/epidemiology
• Drug Interactions
• Drug Therapy, Combination/adverse effects
• Female
• Humans
• Hyperkalemia/chemically induced
• Hyperkalemia/mortality
• Male
• Odds Ratio
• Ontario/epidemiology
• Risk Factors
• Trimethoprim, Sulfamethoxazole Drug Combination/adverse effects

• emergency department testing
• hyperkalemia
• laboratory
• pseudohyperkalemia
• resource utilization

• Endoscopy
• Extended release potassium salts
• Pharmacobezoar

• Apparent mineralocorticoid excess syndrome
• Chloride depletion
• Metabolic alkalosis
• Mineralocorticoid excess syndrome

• Alkalosis/therapy
• Disease Management
• Emergencies
• Emergency Service, Hospital
• Humans

• Hyperkalemia
• Hypokalemia
• Peaked T waves
• Potassium

• Hypokalemia
• hyperkalemia
• treatment

• Child
• Child, Preschool
• Extracellular Space/metabolism
• Female
• Homeostasis/drug effects
• Humans
• Hyperkalemia/blood
• Hyperkalemia/drug therapy
• Hyperkalemia/physiopathology
• Hypokalemia/blood
• Hypokalemia/drug therapy
• Hypokalemia/physiopathology
• Infant
• Kidney/metabolism
• Kidney/physiopathology
• Male
• Muscle, Skeletal/metabolism
• Potassium/blood
• Potassium Channels/drug effects
• Sodium-Potassium-Exchanging ATPase/drug effects
• Water-Electrolyte Balance

• Paco2
• arterial blood gases
• blood electrolytes
• hemorrhage
• intraclass correlation coefficient
• intrainbred strain variation
• oxygen content

We present a case of a potentially lethal ingestion of potassium pills. After presentation, we briefly review the epidemiology and pathology of hyperkalemia.

Burmese is an old and popular cat breed, however, several health concerns, such as hypokalemia and a craniofacial defect, are prevalent, endangering the general health of the breed. Hypokalemia, a subnormal serum potassium ion concentration ([K⁺]), most often occurs as a secondary problem but can occur as a primary problem, such as hypokalaemic periodic paralysis in humans, and as feline hypokalaemic periodic polymyopathy primarily in Burmese. The most characteristic clinical sign of hypokalemia in Burmese is a skeletal muscle weakness that is frequently episodic in nature, either generalized, or sometimes localized to the cervical and thoracic limb girdle muscles. Burmese hypokalemia is suspected to be a single locus autosomal recessive trait. A genome wide case-control study using the illumina Infinium Feline 63K iSelect DNA array was performed using 35 cases and 25 controls from the Burmese breed that identified a locus on chromosome E1 associated with hypokalemia. Within approximately 1.2 Mb of the highest associated SNP, two candidate genes were identified, KCNH4 and WNK4. Direct sequencing of the genes revealed a nonsense mutation, producing a premature stop codon within WNK4 (c.2899C>T), leading to a truncated protein that lacks the C-terminal coiled-coil domain and the highly conserved Akt1/SGK phosphorylation site. All cases were homozygous for the mutation. Although the exact mechanism causing hypokalemia has not been determined, extrapolation from the homologous human and mouse genes suggests the mechanism may involve a potassium-losing nephropathy. A genetic test to screen for the genetic defect within the active breeding population has been developed, which should lead to eradication of the mutation and improved general health within the breed. Moreover, the identified mutation may help clarify the role of the protein in K⁺ regulation and the cat represents the first animal model for WNK4-associated hypokalemia.

• Animals
• Case-Control Studies
• Cats
• DNA Mutational Analysis
• Disease Models, Animal
• Ether-A-Go-Go Potassium Channels/genetics
• Female
• Genome-Wide Association Study/veterinary
• Humans
• Hypokalemia/genetics
• Hypokalemia/pathology
• Male
• Phenotype
• Potassium/blood
• Potassium/metabolism
• Protein Serine-Threonine Kinases/genetics

• R24 OD010928 NIH HHS
• R24 RR016094 NCRR NIH HHS