Significance of Serum Potassium Level at Admission in Organophosphorus Poisoning and Impact on Outcome - A Hospital Based Study from North East India

2021 ◽  
Vol 8 (36) ◽  
pp. 3282-3287
Author(s):  
Bijush Difoesa ◽  
Dibya Jyoti Sharma ◽  
Hari S ◽  
Dipankar Deb
Keyword(s):  
Serum Potassium ◽  
Potassium Level ◽  
Serum Potassium Level ◽  
Normal Serum ◽  
Organophosphate Poisoning ◽  
P Value ◽  
Mortality And Morbidity ◽  
North East ◽  
Organophosphorus Poisoning ◽  
Acute Organophosphorus Poisoning

BACKGROUND Organophosphorus (OP) pesticides are one of the most common cause of morbidity and mortality due to poisoning worldwide especially in agrarian countries like India. Hence it is prudent to undertake a detailed study of clinico-pathological evaluation of OP poisoning and assess the role of serum potassium as an alternative, easy and convenient prognostic indicator in estimating the severity of OP poisoning. This study was undertaken to assess serum potassium levels in patients of acute organophosphorus poisoning and determine association between serum potassium level and outcome in cases of acute organophosphorus poisoning. METHODS This was a prospective observational study conducted in Department of General Medicine, Silchar Medical College & Hospital for one year from 1st June 2019 to 31st May 2020 with a sample size of 100 after satisfying the inclusion and exclusion criteria. Peradeniya organophosphorus poisoning (POP) scale was used for categorizing study population according to severity. RESULTS Among patients who were admitted with organophosphorus poisoning, 72 % of the patients discharged were having normal serum potassium levels on admission, whereas 22 % (n = 22) patients who died had hypokalaemia at the time of admission. The chi-square value for the association between serum potassium and outcome is statistically significant [P value is 0.001 (P < 0.05)]. CONCLUSIONS The serum potassium level on the day of admission was significantly correlated with the severity of the acute organophosphate poisoning as determined by Peradeniya OP poisoning scale. The cases that had lower serum potassium levels on admission had poor outcome. Reduced serum potassium levels also had significant association with the need for ventilator support. Therefore, serum potassium can be used as a predictive marker of severity in organophosphorus poisoning. This can help in early triage of patients and will be helpful in reducing mortality and morbidity. KEYWORDS Organophosphorus Compound Poisoning, Serum Potassium, POP Scale

scholarly journals Effect on serum potassium level in patients of diabetic nephropathy on spironolactone and ramipril over follow up period

2019 ◽  
Vol 7 (12) ◽  
pp. 4691
Author(s):  
Ashish Naresh ◽  
Mahendra Pal Singh ◽  
Richa Giri
Keyword(s):  
Diabetes Mellitus ◽  
Diabetic Nephropathy ◽  
Serum Potassium ◽  
Potassium Level ◽  
Serum Potassium Level ◽  
P Value ◽  
Base Line ◽  
Group A ◽  
Group B

Background: The study was conducted to evaluate the change in serum potassium level over follow up period in patients of diabetic nephropathy on spironolactone (25 mg) and ramipril (5 mg) and compare the results with diabetic nephropathy patients on Spironolactone (25 mg) alone.Methods: A comparative, prospective, non-randomized, non-blinded experimental study was conducted on 56 patients (30-70 yr.) of diagnosed type 2 diabetes mellitus showing proteinuria. Total duration of study was about one year from October 2017 to October 2018. Inclusion criteria followed in study were Age 30-70 years, diagnosed type 2 diabetes mellitus, serum potassium level <5 meq/l, estimated GFR >30 ml/min/1.73m2 and HbA1c <10%. Exclusion criteria were type 1 diabetes mellitus, impaired glucose tolerance secondary to endocrine disease, exocrine pancreatic disease, SBP >180 mmHg DBP >110 mmHg, UTI, hematuria, acute febrile illness, vigorous exercise, short-term pronounced hyperglycemia, obstructive uropathy, confirmed or suspected renal artery disease by USG doppler study, Serum potassium level >5.5 meq/l. Patients were divided in two groups, group A (n= 28, spironolactone 25 mg and ramipril 5 mg) and group B (n=27, spironolactone 25 mg). Subjects were followed over 12 weeks and baseline and 12-week serum potassium being compared. Other baseline base line laboratory investigation such as serum lipid profile, HbA1c, eGFR, fundus examination, ultrasonography (KUB), serum urea, serum creatinine, hemoglobin, were taken at the starting point.Results: Both the group after receiving respective drug were followed for 3-month duration and serum potassium level measured at end of 3 months. Mean values of baseline and follow up serum potassium for group A and group B were 4.24±0.59, 4.07±0.61 and 4.35±0.55, 4.16±0.61 respectively, p value found to be >0.05 at 95% CI.Conclusions: In the study it was concluded that p value found to be >0.05 at 95% C.I denoting that there is no significant difference between mean value of base line and follow up serum potassium value in both group. None of patients in either group had experienced hyperkalaemia over follow up period though serum potassium level were slightly higher in group A, but this difference was statistically not significant. Follow up period of study should be long enough to comment on safety profile of combining spironolactone and ACE inhibitors in diabetic nephropathy patients.

MO727EFFECT OF SACUBITRIL/VALSARTAN ON SERUM POTASSIUM AND BLOOD PRESSURE LEVELS OF DIALYSIS PATIENTS WITH HEART FAILURE

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Renee Mari Gula ◽  
Marichel Coronel ◽  
Russel Villanueva
Keyword(s):  
Heart Failure ◽  
Blood Pressure ◽  
Peritoneal Dialysis ◽  
Diastolic Blood Pressure ◽  
Serum Potassium ◽  
Potassium Level ◽  
Serum Potassium Level ◽  
P Value ◽  
Dialysis Patients

Abstract Background and Aims Heart failure is a frequent complication in patients with chronic kidney disease (CKD). As the kidney function declines, the incidence of heart failure and all-cause mortality increases. Heart failure is treated based on the ejection fraction and most of the treatments are often dependent on the renal function. The treatment guidelines of heart failure are not entirely applicable to those with CKD, since this population is usually not included in the randomized control trials. The introduction of neprilysin-inhibitor changed the paradigm of heart failure with reduced ejection fraction (HFrEF) treatment but the effects on dialysis patients is still under studied. Sacubitril/Valsartan is an ARNI that has been recommended as a treatment for symptomatic HFrEF. Monitoring of renal function and potassium is recommended for patients who will take Sacubitril/Valsartan and the two most common side effects are hyperkalemia and hypotension. This study evaluated the safety of Sacubitril/Valsartan by assessing the incidence of hyperkalemia and hypotension on patients undergoing maintenance dialysis - peritoneal or hemodialysis. The objective of the study was to compare the effect of losartan against sacubitril/valsartan on the systolic blood pressure (SBP), diastolic blood pressure (DBP), and serum potassium level across three time points (1st, 2nd, and 3rd month follow-up). Method This retrospective, cohort, single-center study of dialysis patients with HFrEF is designed to assess the safety of Sacubitril/Valsartan versus Losartan based on the blood pressure and serum potassium level. A total of 96 patients on dialysis diagnosed with HFrEF was included in the study. Half was prescribed with Sacubitril/Valsartan while half was prescribed with Losartan. Serum potassium, systolic and diastolic blood pressure were recorded at baseline and monthly on the first three months of follow-up. Baseline 2d echocardiography was also reviewed. Results There were 96 chronic kidney disease patients with HF; 48 were on peritoneal dialysis and 48 on hemodialysis. Per group, 24 were given Losartan and 24 were given Sacubitril/Valsartan for 3 months. The mean age was 47.5 (15.5) years and ranges from 19 to 78 years old. Sixty two percent were males. The most common diagnosis were glomerulonephritis (36.5%), hypertensive nephrosclerosis (27.1%) and diabetic nephropathy (26%). In this retrospective study, we found that there were no episodes of hypotension and hyperkalemia on both hemodialysis and peritoneal dialysis patients who were prescribed with Sacubitril/Valsartan. All the hemodialysis patients included in this study were maintained on thrice a week hemodialysis sessions and the peritoneal dialysis patients had at least 3 exchanges per day. There were no significant change at three points in time (1st, 2nd, and 3rd month follow-up) in the levels of systolic blood pressure (p-value= 0.780, 0.609, 0.926), diastolic blood pressure (p-value= 0.692, 0.206, 0.527), and serum potassium (p-value= 0.212, 0.084, 0.095) on patients maintained on Sacubitril/Valsartan compared to Losartan. There was no evidence of hyperkalemia or hypotension on dialysis patients taking both medications. Conclusion Sacubitril/Valsartan is recommended in the therapy for HFrEF because of the documented benefits in the non-CKD and non-dialysis CKD patients. In this study, Sacubitril/Valsartan is well tolerated and has same effect on the serum potassium and blood pressure compared to Losartan. We concluded that there was no episode of hyperkalemia and hypotension on dialysis patients taking both medications. For the first time, this study demonstrated that Sacubitril/Valsartan is safe to be used in dialysis patients.

scholarly journals Serum potassium level as a biomarker for acute caffeine poisoning

2020 ◽  
Vol 7 (1) ◽  
Author(s):  
Tomoatsu Tsuji ◽  
Seiji Morita ◽  
Takeshi Saito ◽  
Yoshihide Nakagawa ◽  
Sadaki Inokuchi
Keyword(s):  
Serum Potassium ◽  
Potassium Level ◽  
Serum Potassium Level

scholarly journals The Case of Bradycardia Occured in the Setting of Hyperkalemia in a Patient in Ambulatory Hemodialysis Department

2021 ◽  
Vol 11 (1) ◽  
pp. 60-66
Author(s):  
G. A. Ignatenko ◽  
G. G. Taradin ◽  
A. E. Bagry ◽  
I. V. Rakitskaya ◽  
K. E. Mogilevskaya ◽  
...  
Keyword(s):  
Serum Potassium ◽  
Potassium Level ◽  
Serum Potassium Level ◽  
Kidney Diseases ◽  
Clinical Manifestations ◽  
Junctional Rhythm ◽  
Chronic Kidney Diseases ◽  
Electrolyte Disorder ◽  
Ambulatory Treatment ◽  
Dangerous Condition

The presented article contains the clinical observation of bradycardia development in 64-year-old patient with chronic kidney disease who was in ambulatory treatment at the hemodialysis department. During electrocardiogram recording an arrhythmia was detected as a junctional rhythm. The specific changes on electrocardiogram, presence of risk factors, and data of additional collection of history disease allowed purposing the development of dangerous condition — hyperkalemia. The diagnosis was confirmed after detection of the serum potassium level. This case illustrates the necessity to consider the possibility of hyperkalemia in patients with chronic kidney diseases including those who undergoing hemodialysis treatment. Relevant clinical manifestations and changes on the electrocardiogram require the urgent assessment of the serum potassium level for timely and adequate correction of the electrolyte disorder.

scholarly journals Serum Potassium Levels and Adverse Outcomes in Patients with Acute Myocardial Infarction

Esculapio ◽  
2021 ◽  
Vol 17 (1) ◽  
pp. 5-8
Author(s):  
Rizwan Abbas ◽  
Tazeen Nazar ◽  
Bilal Aziz ◽  
Furqan Saeed ◽  
Kashif Nawaz ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Serum Potassium ◽  
Potassium Level ◽  
Adverse Outcome ◽  
Serum Potassium Level ◽  
Computer Software ◽  
Case Series ◽  
Adverse Outcomes ◽  
Low Serum

Objective: To determine the effect of serum potassium levels on short term mortality outcomes in patients with acute myocardial infarction. Methods: This Descriptive Case Series was conducted in the CCU of Mayo Hospital Lahore from 15th November, 2017 to 15th May, 2018. A total of 156 patients of either sex between the age group of 30-60 years and diagnosed as cases of myocardial infarction with symptoms of less than 24 hours duration and serum potassium level of <3.5 mEq/L were included in the study. Patients were then followed up for 7 days and adverse outcome was recorded. Data was analyzed using computer software SPSS Version 22.0. Results: Out of the 156 patients, 119 (76.3%) were males and 37 (23.7%) were females. Mean age of the patients was 47.88±6.24 years, mean weight 85.31±13.14 Kg, mean duration of presenting complaints was 10.269±4.51 hours and mean Serum Potassium levels were 3.05±0.25 mEq/L. Adverse outcome in the form of mortality due to arrhythmias was seen in 15 (9.6%) patients. Conclusion: Low serum potassium level (<3.5mEq/L/L) was significantly associated with increased adverse outcome in acute myocardial infarction patients. Keywords: Acute myocardial infarction, Low serum potassium levels, Adverse outcome How to cite: Abbas R., Nazar T, Aziz B., Saeed F., Nawaz K., Nabeel M. serum potassium levels and adverse outcomes in patients with acute myocardial infarction. Esculapio 2021;17(01):5-8

The effect of serum potassium level on in-hospital and long-term mortality in ST elevation myocardial infarction

2016 ◽  
Vol 221 ◽  
pp. 505-510 ◽  
Author(s):  
Muhammed Keskin ◽  
Adnan Kaya ◽  
Mustafa Adem Tatlısu ◽  
Mert İlker Hayıroğlu ◽  
Osman Uzman ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Serum Potassium ◽  
Potassium Level ◽  
Serum Potassium Level ◽  
St Elevation Myocardial Infarction ◽  
St Elevation ◽  
Long Term Mortality

HYPERTENSION AND HYPOKALEMIC ALKALOSIS ASSOCIATED WITH UNDERPRODUCTION OF ALDOSTERONE

PEDIATRICS ◽  
1967 ◽  
Vol 39 (6) ◽  
pp. 884-890
Author(s):  
Dagfinn Aarskog ◽  
Karl F. Støa ◽  
Thor Thorsen ◽  
Karl W. Wefring
Keyword(s):  
Blood Pressure ◽  
Differential Diagnosis ◽  
Potassium Level ◽  
Serum Potassium Level ◽  
Sodium Intake ◽  
Normal Serum ◽  
Secretion Rate ◽  
Aldosterone Secretion ◽  
Hypokalemic Alkalosis ◽  
Potassium Retention

A 10-year-old girl presented with a syndrome characterized by hypertension, hypokalemic alkalosis, and inability of the kidneys to concentrate the urine and conserve potassium. The aldosterone excretion and secretion rate were subnormal to low both when she was on a liberal sodium intake and on restricted sodium intake. Treatment with Triamterene resulted in potassium retention , restoration of normal serum potassium level, abolition of the alkalosis, normalization of the blood pressure, and increase of aldosterone secretion rate. The differential diagnosis in conditions associated with hypokalemic alkalosis and renal wastage of potassium is discussed.

The Incidence And Risk Factors of Serum Hypokalemia After Primary Total Joint Arthroplasty

2021 ◽  
Author(s):  
Pin Pan ◽  
Zitao Zhang ◽  
Xiaofeng Zhang ◽  
Qing Jiang ◽  
Zhihong Xu
Keyword(s):  
Risk Factors ◽  
Red Blood Cells ◽  
Knee Replacement ◽  
Serum Potassium ◽  
Total Joint Arthroplasty ◽  
Blood Cells ◽  
Potassium Level ◽  
Serum Potassium Level ◽  
Joint Arthroplasty ◽  
Regular Monitoring

Abstract Background: Regular monitoring of serum potassium after total joint arthroplasty (TJA) is a routine examination, which can detect abnormal serum potassium and reduce adverse events timely caused by postoperative hypokalemia. In this study, we aimed to investigate the incidence and risk factors of hypokalemia after primary total hip and knee replacement.Methods: This study included patients who underwent unilateral total knee or hip arthroplasty in our department from April 2017 to March 2018. The serum potassium level before and after operation was collected and retrospectively analyzed. The differences in age, BMI and other factors between hypokalemia patients and non-hypokalemia patients at different time points after surgery were compared, and then the risk factors of postoperative hypokalemia were analyzed based on multiple logistic regression.Results: The total incidence of postoperative hypokalemia was 53.1%, while the respective rate on the first, third and fifth postoperative day was 12.5%, 40.7% and 9.6%. The serum potassium level on the first, third and fifth postoperative day was 3.84±0.32mmol/l, 3.59±0.34mmol/l and 3.80±0.32mmol/l, while among which, the level on the third day was the lowest (p=0.015). The independent risk factors for hypokalemia after total hip and knee replacement were the level of preoperative serum potassium (p=0.011), preoperative red blood cells (p=0.027), and a history of diabetes (p=0.007).Conclusion: Regular monitoring of serum potassium should be performed after TJA due to hypokalemia was a very common complication. We need to pay more attention to patients’ preoperative potassium and red blood cells, especially patients with diabetes.

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