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Hypokalemic Nephropathy


Presentation

  • The patient presented with profound and persistent hypokalemia secondary to distal renal tubular acidosis (RTA). A renal biopsy exhibited tubular degeneration, marked interstitial fibrosis and intense macrophage infiltration.[ncbi.nlm.nih.gov]
  • Monitoring metabolic changes after proctocolectomy and ileostomy, especially during the defunctionalized stage when temporary ileostomy is still present, is essential.[ncbi.nlm.nih.gov]
  • Leading experts from Latin America, Africa, Near and Middle East, Indian Subcontinent, Far East, Oceania and Australia present their expert insights into specific conditions, as well as progress and challenges in the development of the specialty.[books.google.com]
  • At the onset of present illness her thirst increased and she consumed as much as 5 L per day, mostly Coca- Cola and water.[symbiosisonlinepublishing.com]
  • More than 700 full-color high-quality photographs as well as carefully chosen figures, algorithms, and tables to illustrate essential concepts, nuances of clinical presentation and technique, and decision making provide a visual grasp and better understanding[books.google.com]
Polydipsia
  • Hypokalemia can lead to a renal concentrating defect leading to polyuria and polydipsia- DI 2. Chronic tubular damage can occur as a result and lead to proximal tubular damage as well 3. Tubular interstitial disease develops 4.[nephronpower.com]
  • Main symptom of hypokalemia is renal tubules lesion, characterized with hypocondensation, polydipsia, diuresis, increased nocturia, nephrogenic diabetes insipidus(NDI), protein urine and cast in urine.[m.pkdclinic.org]
  • […] salt-losing nephritis. hy·po·ka·le·mic ne·phrop·a·thy vacuolation of the epithelial cytoplasm of renal convoluted tubules in people seriously depleted of potassium; vacuoles do not contain fat or glycogen, concentrating ability is impaired, polyuria and polydipsia[medical-dictionary.thefreedictionary.com]
  • Patients with hypokalemic nephropathy present with nocturia, polyuria and polydipsia, associated with collecting tubule responsiveness to vasopressin.[symbiosisonlinepublishing.com]
  • After birth, the infant is seen to urinate and drink excessively ( polyuria, and polydipsia, respectively). Life-threatening dehydration may result if the infant does not receive adequate fluids.[en.wikipedia.org]
Muscle Weakness
  • There is generalized muscle weakness, characterized by ventroflexion of the neck; other signs include weight loss, chronic vomiting and constipation. Cervical ventroflexion in a cat with hypokalemic polymyopathy.[medical-dictionary.thefreedictionary.com]
  • Under treatment in next 4 days her serum potassium gradually elevated to normal range, ECG showed sinus rhythm, muscle weakness partially resolved; urine output became 3500 ml/day.[symbiosisonlinepublishing.com]
  • Careful monitoring of electrocardiogram changes and muscle weakness in hyperkalemia is important to determine its functional consequences. If these are observed to be severe, immediate correction of hyperkalemia is essential.[acls.com]
  • Due to muscle weakness and cramping, exercise is not effective during the state of hypokalemia.[physio-pedia.com]
  • Hypokalemia in dRTA is sometimes severe and produces muscle weakness.[freethesaurus.com]
Meningism
  • February 29 she was admitted to the infectious disease hospital, suspected with meningitis. She was conscious, alert, RR 24 per minute, BP 120/70 mm Hg, HR 88 per minute.[symbiosisonlinepublishing.com]
Polyuria
  • Hypokalemia can lead to a renal concentrating defect leading to polyuria and polydipsia- DI 2. Chronic tubular damage can occur as a result and lead to proximal tubular damage as well 3. Tubular interstitial disease develops 4.[nephronpower.com]
  • Patients with hypokalemic nephropathy present with nocturia, polyuria and polydipsia, associated with collecting tubule responsiveness to vasopressin.[symbiosisonlinepublishing.com]
  • Called also salt-losing nephritis. hy·po·ka·le·mic ne·phrop·a·thy vacuolation of the epithelial cytoplasm of renal convoluted tubules in people seriously depleted of potassium; vacuoles do not contain fat or glycogen, concentrating ability is impaired, polyuria[medical-dictionary.thefreedictionary.com]
  • Natural History If left untreated, hypokalemia may present as nausea, vomiting that progresses to develop ileus, muscle cramps, rhabdomyolysis and polyuria leading to dehydration.[wikidoc.org]
  • Genitourinary Polyuria or sexual dysfunction. [2] Medical Management (current best evidence) Severe hypokalmeia levels that cause ECG changes such as T-wave flattening or prominent U waves require hospital admission.[physio-pedia.com]
Nocturia
  • Main symptom of hypokalemia is renal tubules lesion, characterized with hypocondensation, polydipsia, diuresis, increased nocturia, nephrogenic diabetes insipidus(NDI), protein urine and cast in urine.[m.pkdclinic.org]
  • Patients with hypokalemic nephropathy present with nocturia, polyuria and polydipsia, associated with collecting tubule responsiveness to vasopressin.[symbiosisonlinepublishing.com]
  • Type or etiology Causes/risk factors Features Analgesic nephropathy Excessive analgesic use 3 y in various combinations, including NSAIDs; more frequent in women Hypertension, nocturia, sterile leukocyturia, hemolytic anemia; characteristic papillary[empendium.com]
  • […] between gender and race. [3] Characteristics/Clinical An individual with Hypokalemia may exhibit signs of the following: Abnormal heart rhythyms Constipation Fatigue Muscle Damage Muscle Weakness or spasms Paralysis [2] Nausea and vomiting Polyuria, nocturia[physio-pedia.com]
  • Urinary concentration defects (secondary to dysfunction of the kidney concentrating mechanism located in the medulla Occurs early in the course Associated: nocturia, polyuria and nephrogenic diabetes insipidus (NDI) with complications of dehydration Sodium[renalandurologynews.com]

Workup

  • MEDICAL WORKUP Patients should have a complete medical evalua-tion,including abdominal and thoracic imaging, urinalysis, and serum biochemical analysis. Imaging ...[nephropathygotsuesa.blogspot.com]
Thrombocytosis
  • Neurological exam did not reveal any meningeal signs but confirmed tetraparsesis, work-up showed moderate leukocytosis with normal differential count, thrombocytosis, mild hyperglycemia and high CK level with normal CK-MB (Tables 1,2).Anti-CMV and Anti-EBV[symbiosisonlinepublishing.com]

Treatment

  • All abnormalities cleared with potassium replacement, salt restriction, modest thiazide treatment, and abstinence from Big Red.[ncbi.nlm.nih.gov]
  • When hypokalemia is found, replacement treatment should be instituted and maintained as long as the eating disorder symptoms persist. — JY[eatingdisordersreview.com]
  • Singh Springer Science & Business Media, ٢٧‏/٠٨‏/٢٠١٣ - 418 من الصفحات Core Concepts in Parenchymal Kidney Disease provides comprehensive and state-of-the-art information on the diagnosis, treatment, classification and pathogenesis of glomerular and tubulointerstitial[books.google.com]
  • Get Document Merck Manual Chronic Renal Failure - WordPress.com Learn about Acute Kidney Injury symptoms, diagnosis and treatment in the Merck Manual.[nephropathygotsuesa.blogspot.com]
  • Further treatment and follow-up: Patient was discharged from ICU and treated with oral potassium formulations in nephrology unit for next 8 days.[symbiosisonlinepublishing.com]

Prognosis

  • Complications Possible complications include [1] : Paralysis : In severe cases Arrhythmia Heart block and cardiac arrest Rhabdomyolysis Hepatic encephalopathy in cirrhotic patients Constipation Prognosis The prognosis depends on underlying condition that[wikidoc.org]
  • With early treatment of the electrolyte imbalances, the prognosis for patients with classic Bartter Syndrome is good. History [ edit ] The condition is named after Dr. Frederic Bartter, who, along with Dr.[en.wikipedia.org]
  • Outlook (Prognosis) Taking potassium supplements can usually correct the problem. In severe cases, without proper treatment a severe drop in potassium levels can lead to serious heart rhythm problems that can be fatal.[healthmedicinet.com]
  • Prognosis for complete recovery of renal function is excellent if treatment is initiated rapidly. In patients with normal cardiac and renal function, treatment is usually with allopurinol plus aggressive IV hydration with normal saline.[merckmanuals.com]
  • Outlook (Prognosis) Return to top Taking potassium supplements can usually correct the problem. Without proper treatment, potassium levels in severe cases can drop low enough to cause death.[pacificschoolserver.org]

Etiology

  • Edit Synonym: low potassium German : Hypokaliämie 1 Definition Hypokalemia is defined as a serum potassium level below 3.6 mmol/l. 2 Etiology There are several mechanisms that can lead to hypokalemia: Increased secretion, with the possibilities of: Primary[flexikon.doccheck.com]
  • Type or etiology Causes/risk factors Features Analgesic nephropathy Excessive analgesic use 3 y in various combinations, including NSAIDs; more frequent in women Hypertension, nocturia, sterile leukocyturia, hemolytic anemia; characteristic papillary[empendium.com]
  • […] in hospital admission. [3] Other tests may include: arterial blood gas basic or comprehensive metabolic panel Blood tests will also be administered to check the following: glucose magnesium calcium sodium phosphorus thyroxine aldosterone levels. [5] Etiology[physio-pedia.com]
  • The etiology is not completely understood, but bacterial infections, mainly E. coli, and urinary obstruction are very important in the pathogenesis.[kidneypathology.com]
  • […] in only a small proportion of patients Renal biopsy – granulomatous inflammatory infiltrate is confined to the cortex (versus drug-induced interstitial nephritis, predilection for corticomedullary junction (Figure 2) Need to consider other potential etiologies[renalandurologynews.com]

Epidemiology

  • “Lead-related nephrotoxicity: A review of the epidemiologic evidence”. Kidney International. vol. 70. 2006. pp. 2074-2084. Evans, M, Elinder, C-G. “Chronic renal failure from lead: myth or evidence-based fact”.[renalandurologynews.com]
  • Renal failure secondary to acute tubular necrosis: epidemiology, diagnosis, and management. Chest. 2005;128:2847-63. PubMed link Devarajan P. Cellular and molecular derangements in acute tubular necrosis. Curr Opin Pediatr. 2005;17:193-9.[kidneypathology.com]
Sex distribution
Age distribution

Pathophysiology

  • From basic science and pathophysiology to clinical best practices, Brenner & Rector’s The Kidney is your go-to resource for any stage of your career.[books.google.com]
  • Brenner/Rector remains the go-to resource for practicing and training nephrologists and internists who wish to master basic science, pathophysiology, and clinical best practices.[books.google.com]
  • Pathophysiological consequences of excessive aldosterone secreted are related to the increase in sodium and water retention, and increased potassium excretion, which can trigger systemic arterial hypertension and severe hypokalemia , respectively.[freethesaurus.com]
  • Cola-induced hypokalaemia: pathophysiological mechanisms and clinical implications. Int J Clin Pract. 2009;63(6):900-2. doi: 10.1111/j.1742-1241.2009.02051.x.[symbiosisonlinepublishing.com]
  • In: The Kidney: Physiology and Pathophysiology, Seldin DW, Giebisch G (Eds), Lippincott Wiliams & Wilkins, 2000. p. 1615. Mount DB, Zandi-Nejad, K. Disorders of Potassium Balance. In: Brener and Rector’s The Kidney, 8 th ed, Brenner BM (Ed), W.B.[acls.com]

Prevention

  • Prevention of acute urate nephropathy is indicated for patients at high risk (eg, those at risk of tumor lysis syndrome).[merckmanuals.com]
  • Prevention Eating a diet rich in potassium can help prevent hypokalemia.[healthmedicinet.com]
  • Superoxide Dismutase: A Primary Antioxidant Wrinkle Prevention and Delaying the Aging Process SOD has Health Protective Properties With Over 5,000 Units of SOD Per Face Mask Superoxide Dismutase- A Primary Antioxidant Antioxidants are the body's first[uniqueproductsofnature.com]
  • Prevention Return to top Eating a diet rich in potassium can help prevent hypokalemia.[pacificschoolserver.org]
  • Treatment of hypokalemic periodic paralysis focuses on preventing further attacks and relieving acute symptoms. Gossypol induced hypokalemic paralysis is easily treatable with potassium repletion.[diki.pl]

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