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Sailing Between Scylla and Charybdis: The High Serum K-Low Dialysate K Quandary.
MedLine Citation:
PMID:  24824161     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
In HD patients, the optimal choice of dialysate K concentration is of paramount importance. Recent large observational studies have documented an association between low dialysate K concentration (< 2 or even <3 mEq/L) and a higher risk of sudden death. In this review, we first briefly discuss the available data concerning the link between hypokalemia and negative outcomes in non-CKD populations, especially after an acute myocardial infarction or in congestive heart failure. We next review the pathophysiology of the arrhythmogenic effect related to K fluxes during HD and discuss the dialytic strategies aiming at making potassium fall more gradual and thus at reducing the electrical disturbances triggered by the HD session. We conclude with practical recommendations regarding the optimal choice of K bath and the importance of more frequent monitoring of serum K in some clinical scenarios.
Authors:
Laura Labriola; Michel Jadoul
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-5-14
Journal Detail:
Title:  Seminars in dialysis     Volume:  -     ISSN:  1525-139X     ISO Abbreviation:  Semin Dial     Publication Date:  2014 May 
Date Detail:
Created Date:  2014-5-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8911629     Medline TA:  Semin Dial     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2014 Wiley Periodicals, Inc.
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