Investigation of outpatients referred to a chemical pathologist with potential pseudohyperkalaemia

2009 ◽  
Vol 62 (10) ◽  
pp. 920-923 ◽  
Author(s):  
A K Kapoor ◽  
A Ravi ◽  
P J Twomey
Keyword(s):  
Major Part ◽  
Systematic Approach ◽  
Potassium Concentration ◽  
Plasma Potassium ◽  
Full Blood Count ◽  
Haematological Abnormality ◽  
Blood Potassium ◽  
Male Patients

Background:Pseudohyperkalaemia is when the in vitro blood potassium concentration is artefactually raised while the in vivo concentration is normal. With unexplained hyperkalaemia, pseudohyperkalaemia needs to be excluded to avoid unnecessary and potentially detrimental therapy. There are numerous causes, but no systematic approach for the investigation of outpatients with potential pseudohyperkalaemia exists in the literature.Aims:To evaluate the in-house protocol.Methods:Patients referred for investigation of potential pseudohyperkalaemia underwent an outpatient based protocol which is designed to determine whether the cause was due to delayed blood separation, clotting, centrifugation or a haematological abnormality.Results:32 patients with serum potassium of 5.5–7.1 mmol/l were referred. All patients had pseudohyperkalaemia; the most frequent causes were full blood count (FBC) abnormalities (28%), time >4 hours from sampling to centrifugation (28%) and sample clotting (25%). Anaemia was more likely to be found in male patients.Conclusion:Before a problem can be treated, it must be confirmed and its aetiology identified. A systematic approach to investigate potential pseudohyperkalaemia has been presented. This confirmed the clinician’s suspicion of pseudohyperkalaemia and in the majority of patients the aetiology was also identified. The use of serum and plasma potassium with an FBC in the initial investigation will identify whether clotting or a haematological abnormality is the cause in about half of the cases. Assay of whole-blood potassium is less important as centrifugation is a rare cause. Time to centrifugation is likely to play a major part in the majority of the remaining cases.

scholarly journals Association between Blood Potassium Level and Recovery of Postoperative Gastrointestinal Motility during Continuous Renal Replacement Therapy in Patient Undergoing Open Abdominal Surgery

2019 ◽  
Vol 2019 ◽  
pp. 1-8
Author(s):  
Yi Yang ◽  
Jingjuan Yang ◽  
Xiner Yao ◽  
Yu Cui ◽  
Xiabing Lang ◽  
...  
Keyword(s):  
Abdominal Surgery ◽  
Gastrointestinal Motility ◽  
Potassium Level ◽  
Potassium Concentration ◽  
Binary Logistic Regression ◽  
Plasma Potassium ◽  
Postoperative Recovery ◽  
Binary Logistic Regression Model ◽  
Open Abdominal Surgery ◽  
Blood Potassium

Background. The aim of this study was to identify the blood potassium level beneficial to the postoperative recovery of gastrointestinal motility during continuous renal replacement therapy (CRRT) in patient undergoing open abdominal surgery. Materials and Methods. 538 critically ill patients after open abdominal surgery and receiving CRRT were retrospectively recruited as the study cohort. Demographic and clinical data were recorded along with an evaluation of the postoperative gastrointestinal motility. Results. Correlation analysis was used to assess the correlation coefficient, and then the variables with correlation coefficient value less than 0.5 were included in the binary logistic regression model. Binary logistic regression model indicated that the postoperative blood potassium level was independently associated with the recovery of gastrointestinal motility (OR=0.109, 95% CI= 0.063 to 0.190, p<0.001). Based on the normal range of blood potassium level, we selected the cut-off point of blood potassium level via Weight of Evidence analysis, which was 4.00 mmol/L. Compared with the patients with insufficient blood potassium levels (plasma potassium concentration < 4.00 mmol/L), those with sufficient blood potassium levels (plasma potassium concentration≥ 4.00 mmol/L) conferred an increase in the rate of 4-day postoperative recovery of gastrointestinal motility (OR= 4.425, 95% CI = 2.933 to 6.667, p<0.001). Conclusions. Maintaining the blood potassium concentrations at a relatively high level of the normal blood potassium range during CRRT would be beneficial to postoperative recovery of gastrointestinal motility.

Long-term Adaptations of Sabella Giant Axons to Hyposmotic Stress

1978 ◽  
Vol 75 (1) ◽  
pp. 253-263
Author(s):  
J. E. TREHERNE ◽  
Y. PICHON
Keyword(s):  
Sea Water ◽  
Potassium Concentration ◽  
Resting Potential ◽  
Sodium Permeability ◽  
Bathing Medium ◽  
Appreciable Change ◽  
Axon Membrane ◽  
Giant Axons

Reprint requests should be addressed to Dr Treherne. Sabella is a euryhaline osmoconformer which is killed by direct transfer to 50% sea water, but can adapt to this salinity with progressive dilution of the sea water. The giant axons were adapted to progressive dilution of the bathing medium (both in vivo and in vitro) and were able to function at hyposmotic dilutions (down to 50%) sufficient to induce conduction block in unadapted axons. Hyposmotic adaptation of the giant axon involves a decrease in intracellular potassium concentration which tends to maintain a relatively constant resting potential during adaptation despite the reduction in external potassium concentration. There is no appreciable change in the intracellular sodium concentration, but the relative sodium permeability of the active membrane increases during hyposmotic adaptation. This increase partially compensates for the reduction in sodium gradient across the axon membrane, during dilution of the bathing media, by increasing the overshoot of the action potentials recorded in hyposmotically adapted axons.

Xanthine oxidase inhibitory activity of nicotino/isonicotinohydrazides: A systematic approach from in vitro , in silico to in vivo studies

2017 ◽  
Vol 25 (8) ◽  
pp. 2351-2371 ◽  
Author(s):  
Humaira Zafar ◽  
Muhammad Hayat ◽  
Sumayya Saied ◽  
Momin Khan ◽  
Uzma Salar ◽  
...  
Keyword(s):  
Xanthine Oxidase ◽  
Inhibitory Activity ◽  
In Silico ◽  
Systematic Approach ◽  
In Vivo Studies

THE EFFECT OF MUSCULAR EXERCISE ON PLASMA SODIUM AND POTASSIUM IN THE RAT

1958 ◽  
Vol 36 (3) ◽  
pp. 333-338 ◽  
Author(s):  
F. A. Sréter ◽  
Sydney M. Friedman
Keyword(s):  
Potassium Concentration ◽  
Plasma Potassium ◽  
Sodium Concentration ◽  
Plasma Sodium ◽  
Preliminary Training ◽  
Plasma Sodium Concentration ◽  
Rate Of Increase ◽  
Response To Exercise ◽  
Sodium And Potassium

After running a distance of 100 meters in 7 minutes, untrained rats showed a rise in plasma potassium and a fall in plasma sodium as measured in tail vein samples. These changes are in accord with in vitro observations of the effects of exercise on isolated muscle preparations and similarly are taken to indicate a gain of sodium and a loss of potassium by the exercised muscles in the whole animal. Within 10 minutes of completion of the exercise, plasma sodium concentration was restored to normal while potassium was restored within 20 minutes. Exercise was accompanied by a fall in haematocrit, which remained low for up to 40 minutes. A period of 2 months of preliminary training modified the response to exercise. In these trained animals, a fall in sodium concentration occurred as before but the rise in potassium concentration was less in degree and the haematocrit did not change. It is suggested that the rate of increase of plasma potassium is an index of muscle efficiency while the height of plasma potassium is correlated with the fatigue limit of exercise.

scholarly journals Blood to Brain Sodium Transport and Interstitial Fluid Potassium Concentration during Early Focal Ischemia in the Rat

1991 ◽  
Vol 11 (3) ◽  
pp. 466-471 ◽  
Author(s):  
Gerald P. Schielke ◽  
Hylan C. Moises ◽  
A. Lorris Betz
Keyword(s):  
Sodium Transport ◽  
Interstitial Fluid ◽  
Potassium Concentration ◽  
Capillary Endothelium ◽  
Extracellular Potassium ◽  
Sprague Dawley ◽  
Ischemic Tissue ◽  
The Right

During partial ischemia, sodium and potassium ions exchange across the blood–brain barrier, resulting in a net increase in cations and brain edema. Since this exchange is likely mediated by specific transporters such as Na,K–ATPase in the capillary endothelium and because brain capillary Na,K–ATPase activity is stimulated by increased extracellular potassium in vitro, this study was designed to determine if the rate of blood to brain sodium transport is increased in ischemic tissue having an elevated interstitial fluid potassium concentration ([K]ISF) in vivo. Sprague-Dawley rats were studied between 2–3 h after occlusion of the right middle cerebral artery. To identify where cortical tissue with an elevated [K]ISF could be sampled for transport studies, the regional pattern of cerebral blood flow and [K]ISF was obtained in a group of 17 rats using hydrogen clearance and potassium-selective microelectrode techniques. We observed severely elevated [K]ISF (> 10 m M) when CBF was less than 20 ml 100 g−1 min−1 and mildly elevated levels at CBF between 20–45 ml 100 g−1 min−1. In a second group of seven rats, permeability-surface area products (PS products) for 22Na and [3H]α-aminoisobutyric acid ([3H]AIB) were determined in ischemic cortex with elevated [K]ISF and in nonischemic cortex. The PS products for AIB were similar in both tissues (2.2 ± 0.7 and 2.1 ± 0.4 μl/g/min) while the PS products for sodium was significantly increased in the ischemic tissue (1.5 ± 0.2 and 2.4 ± 1.1 μl/g/min). This study demonstrates that blood to brain sodium transport is increased in ischemic tissue at early times before the BBB is disrupted. Stimulation of the Na,K pumps in the capillary endothelium by elevated [K]ISF may mediate this effect.

scholarly journals The Necessity of a Systematic Approach for the Use of MSCs in the Clinical Setting

2013 ◽  
Vol 2013 ◽  
pp. 1-10 ◽  
Author(s):  
Christophe Michel Raynaud ◽  
Arash Rafii
Keyword(s):  
Clinical Trials ◽  
Stromal Cells ◽  
Therapeutic Strategy ◽  
Systematic Approach ◽  
Cell Types ◽  
Clinical Applications ◽  
Physiological Properties ◽  
Different Cell Types

Cell therapy has emerged as a potential therapeutic strategy in regenerative disease. Among different cell types, mesenchymal stem/stromal cells have been wildly studiedin vitro,in vivoin animal models and even used in clinical trials. However, while clinical applications continue to increase markedly, the understanding of their physiological properties and interactions raises many questions and drives the necessity of more caution and supervised strategy in their use.

scholarly journals EXPERIMENTAL CHRONIC GLOMERULITIS

1968 ◽  
Vol 127 (4) ◽  
pp. 819-832 ◽  
Author(s):  
Theodore Pincus ◽  
Roy Haberkern ◽  
Charles L. Christian
Keyword(s):  
Bovine Serum Albumin ◽  
Bovine Serum ◽  
Major Part ◽  
Chronic Glomerulonephritis ◽  
Soluble Complex ◽  
Chronic Nephritis ◽  
Rapid Removal

Three of 16 rabbits injected (intravenously) daily with crystalline bovine serum albumin (BSA) for periods in excess of 10 wk developed chronic glomerulonephritis. In vivo, animals with chronic proteinuria formed variable quantities of soluble complex after injection of antigen while animals without proteinuria exhibited rapid removal of the injected BSA. In vitro studies demonstrated that a major part of the antibodies produced by rabbits with chronic nephritis lacked precipitating properties. Interpretations of these observations were presented in the discussion. It is suggested that, in addition to quantity, quality of antibody plays an important role in the development of chronic serum sickness. Complexes formed with nonprecipitating antibody, which are less rapidly removed from circulation, would have a greater opportunity to deposit in glomeruli and induce inflammation.

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