Tag Archives: hyperkalaemia

Hyperkalaemia in heart failure HK is a potentially life-threatening electrolyte abnormality. There is no universal definition of HK; however, a serum level greater than 5.0–5.5 mmol/L is generally regarded as abnormal.4 The Swedish heart failure registry showed an increased mortality associated with abnormal serum potassium.5 Hypokalaemia is associated with increased long-term mortality, as opposed to HK’s association with increased short-term mortality.5 The incidence of HK in heart failure remains highly variable.4,6,7 In PARADIGM-HF, enalapril was compared with the combination drug sacubitril/valsartan. The latter had a hazard ratio of

Hyperkalaemia in heart failure HK is a potentially life-threatening electrolyte abnormality. There is no universal definition of HK; however, a serum level greater than 5.0–5.5 mmol/L is generally regarded as abnormal.4 The Swedish heart failure registry showed an increased mortality associated with abnormal serum potassium.5 Hypokalaemia is associated with increased long-term mortality, as opposed to HK’s association with increased short-term mortality.5 The incidence of HK in heart failure remains highly variable.4,6,7 In PARADIGM-HF, enalapril was compared with the combination drug sacubitril/valsartan. The latter had a hazard ratio o

Tafamidis – a new treatment for amyloidosis The European Commission (EC) has granted marketing authorisation for tafamidis (Vyndaqel®, Pfizer), a once-daily 61 mg oral capsule, for the treatment of wild-type or hereditary transthyretin amyloidosis in adult patients with cardiomyopathy (ATTR-CM). Tafamidis is the first authorised treatment in the European Union for patients with ATTR-CM. Prior to this authorisation, treatment options for patients with ATTR-CM were restricted to symptom management, and, in rare cases, heart (or heart and liver) transplant. ATTR-CM is a rare, under-diagnosed and life-threatening disease characterised by the b

Introduction Modulation of the RAAS is an integral part of the management for patients with chronic heart failure, prior myocardial infarction and diabetic nephropathy. Evidence from large scale trials demonstrates the clear prognostic benefit of angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers, mineralocorticoid receptor antagonists and more recently angiotensin receptor neprilysin inhibitors for these high-risk groups.1-3 The use of these agents, particularly in combination, can be associated with hyperkalaemia, although the incidence is unknown.4 A clear trend exists between the development of hyperkalaemia and

Do new diabetes drugs protect the heart and kidney? The day’s keynote session was given by Professor Johannes Mann (Friedrich Alexander University of Erlangen, Germany). Diabetes management has been transformed with the introduction of newer agents with the promise of cardiovascular and renal protection. The sodium glucose co-transporter-2 (SGLT-2) inhibitors are known to reduce the hyperfiltration, which occurs in early diabetic nephropathy. Glucagon-like peptide 1 (GLP-1) receptor agonists are incretin mimetics, which have several benefits for diabetes management. The mechanisms by which GLP-1 agonist therapy may reduce blood pressur

Hyperkalaemia is often multifactorial in origin and may be seen in chronic kidney disease (CKD), acute kidney injury, heart failure, diabetes, elderly patients and those prescribed renin-angiotensin-aldosterone-system (RAAS) antagonists. This important area is often somewhat neglected by healthcare professionals. Left untreated, high potassium increases the risk of mortality in CKD and can also result in increased risk of serious cardiac arrhythmia and other acute complications. Chronically it may result in patients with heart failure having symptom and life-improving treatments withdrawn. New therapies for hyperkalaemia are now coming throu

Presenters included cardiologists, Professors Michael Boehm (University of the Saarland, Homburg, Saarland, Germany) and Stefan Anker (University Medical Center Göttingen, Göttingen, Germany) and nephrologist, Matthew Weir (University of Maryland Medical Centre, Baltimore, Maryland, USA). Their presentations are summarised below. The addition of mineralocorticoid receptor antagonists (MRAs) to angiotensin converting enzyme (ACE) inhibition or receptor blockade (ARB) has been shown in randomised-controlled trials to improve morbidity and mortality in patients with heart failure.1,2 In the EMPHASIS-HF study, the addition of eplerenone in pat

A new gene therapy that targets the heart and requires only one treatment session, has been found safe for patients with coronary artery disease, according to a successful trial carried out in Finland (doi: 10.1093/eurheartj/ehx352). The treatment enhances circulation in ischaemic heart muscle and the effects were still visible one year after treatment. The randomised, blinded, placebo-controlled phase 1/2a trial was carried out in collaboration between the University of Eastern Finland, Kuopio University Hospital and Turku PET Centre. The biological bypass is based on gene transfer in which a natural human growth factor, AdVEGF-DΔNΔC, a ne

Case report An 86-year-old man presented to Accident and Emergency (A&E) feeling generally unwell and increasingly confused. Following an assessment, the doctors diagnosed a urinary tract infection (confirmed on dipstick) and discharged him with a standard course of trimethoprim. After a few days, he was readmitted with falls and increasing lethargy. Figure 1. Patient’s electrocardiogram (ECG) on admission – characteristic of severe hyperkalaemia His electrocardiogram (ECG) on admission showed widened QRS complexes and significantly prolonged QT/QTc intervals (figure 1). Figure 2. Patient’s ECG following treatment – complexes retu

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