Hyperkalemia in chronic kidney disease

Watanabe, Renato

doi:10.1590/1806-9282.66.s1.31

Cited by 37 publications

(44 citation statements)

References 31 publications

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“…This model does not take into consideration additional negative health consequences of potassium reformulated salt, for example the risk of hyperkalaemia in people with advanced kidney disease or diabetes [54]. On balance however, the model does not take into consideration the known bene cial effect of potassium on blood pressure in the general population [55] nor does it consider the lowered risk of stomach cancer [56].…”

Section: Discussionmentioning

confidence: 99%

“…The cost of care in Vietnam also varies greatly on factors such as geographical location [53], and as the costing studies used in this model are generally from hospitals in major urban cities the cost may not be representative of the true cost of stroke and IHD treatment in nonurban areas in Vietnam. This model does not take into consideration additional negative health consequences of potassium reformulated salt, for example the risk of hyperkalaemia in people with advanced kidney disease or diabetes [54]. On balance however, the model does not take into consideration the known bene cial effect of potassium on blood pressure in the general population [55] nor does it consider the lowered risk of stomach cancer [56].…”

Section: Discussionmentioning

confidence: 99%

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The cost-effectiveness of government actions to reduce sodium intake through salt substitutes in Vietnam

Taylor¹,

Hoek²,

Deltetto

et al. 2021

Preprint

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Background Dietary sodium reduction is recommended to reduce the burden of cardiovascular disease. In Vietnam food products including salt, fish sauce and bot canh contribute to ~70% of dietary sodium intake. Reduced sodium versions of these products can be produced by replacing some of the sodium chloride with potassium chloride. We aimed to assess the cost-effectiveness of three alternative approaches to introducing reduced sodium products onto the market with a view to lowering population sodium intake in Vietnam.Methods The three salt substitution strategies included voluntary, subsidised and regulatory approaches targeting salt, fish sauce and bot canh products. Costs were modelled using the WHO-CHOICE methodology. A Markov cohort model was developed to evaluate the cost-effectiveness of each strategy versus no intervention from the government perspective. The model linked each intervention strategy to assumed changes in levels of sodium intake and then to systolic blood pressure. Changes in SBP were linked to a probability of ischaemic heart disease or stroke. The model followed people over their lifetime to assess average costs and quality adjusted life years (QALYs) gained for each strategy. Results The voluntary salt substitution strategy was assumed to require no investment by government. Following ramp up (years 6+), the average annual costs for the subsidised and regulatory strategies were 21,808,968,902 ₫ (US$ 977,354) and 12,949,953,247 ₫ (US$ 580,410) respectively. Relative to no intervention, all three salt substitution strategies were found to be cost-effective. Cost savings were driven by reductions in strokes (32,595; 768,384; 2,366,480) and ischaemic heart disease (IHD) events (22,830; 537,157; 1,648,590) for the voluntary, subsidised & regulatory strategies, respectively. The voluntary strategy was least cost-effective (-3,445 ₫ US$ -0.15; 0.009 QALYs gained) followed by the subsidised strategy (-43,189 ₫ US$ -1.86; 0.022 QALYs gained) and the regulatory strategy delivered the highest cost savings and health gains (-243,530 ₫ US$ -10.49; 0.074 QALYs gained). Conclusion This research shows that all three modelled salt substitution strategies would be good value for money relative to no intervention in Vietnam. The subsidised alternative would require the highest level of government investment; however the implementation costs will be exceeded by healthcare savings assuming a reasonable time horizon is considered.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The cost-effectiveness of government actions to reduce sodium intake through salt substitutes in Vietnam

Taylor¹,

Hoek²,

Deltetto

et al. 2021

Preprint

View full text Add to dashboard Cite

show abstract

“…Limitation of potassium level out of the normal level is classified into three categories, mild potassium level with 5.0 to 5.9 mmol/L, moderate with 6.0 to 6.4 mmol/L, and severe with not less than 6.5 mmol/L accompanied by experienced clinical symptoms by the patient including muscle weakness, paresthesia, paralysis, nausea, shortness of breath, hypotension, and cardiac arrhythmias. Hence, in aiming to suppress the hyperkalemia effect from antihypertensive drug interaction in CKD patients, several monitoring activities are needed to be conducted, including monitoring potassium levels regularly up to 2 weeks after antihypertensive drug dosage adjustment, monitoring kidney function, and also monitoring of heart function in hyperkalemia patients with abnormalities found on the electrocardiogram examination results (Watanabe, 2020).…”

Section: Impact and Handling Of The Antihypertensive Drugs Interactiomentioning

confidence: 99%

Review of Impact and Handling of Potential Antihypertensive Drug Interactions in Chronic Kidney Disease Patients

Susilawati

Halimah

Saidah

2021

JFG

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Drug interaction is a type of Drug-Related Problems (DRPs) that caneventually increase morbidity and mortality rates. CKD patients have asignificant risk of developing polypharmacy due to comorbid diseases andpharmacokinetics' alteration. The literature review was conducted byexploring all of the articles related to the drug interaction using druginteraction analysis program in CKD patients, which obtained from threedatabases, namely Google Scholar, PubMed, and Science Direct, usingseveral keywords combination. Based on the comprehensive reviewsconducted, it is known that the most common effects of antihypertensivedrug interactions in CKD patients are decreasing effects of antihypertensivedrugs, hypotension, and hyperkalemia. Handling management used for theemergence of potential drug interactions is based on the severity of the druginteractions and complete knowledge of the patients' clinical condition. Themanagement of drug interaction by monitoring blood pressure, diuresis, andpotassium levels; Monitor the related effect symptoms; Monitor the fluidand body weight; Monitor the kidney and heart function. On the conditionwhere the handling management of potential drug interactions is not carriedout, elevated morbidity and mortality rates are the risks of complicationsarising from the drug interactions.

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“…Potassium is the most abundant intracellular ion with a concentration of about 98%; it has many biological functions such as cellular metabolism and acid-base homeostasis [74]. It is also vital for cardiac function, neural transmission, muscular contractions, and glucose metabolism [76].…”

Section: Potassiummentioning

confidence: 99%

“…Hyperkalemia is a severe metabolic condition that is often experienced in patients with CKD. The kidneys' ability to excrete potassium is inversely related to a decline in GFR [74]. Hyperkalemia alters the nervous system's mechanisms causing electrophysiological dysfunctions [76], presenting clinical manifestations such as muscle weakness, paresthesia, paralysis, nausea, hypotension, cardiac arrhythmias, and cardiac arrest [76].…”

Section: Potassiummentioning

confidence: 99%

Chronic Kidney Disease: Role of Diet for a Reduction in the Severity of the Disease

Naber¹,

Purohit²

2021

Preprint

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Chronic kidney disease is a critical health crisis in the US, affecting about 37 million adults. Known as "the silent killer" because it is often undiagnosed until it has reached a stage of progression. Renal dysfunction causes many adverse effects to the body's biological mechanisms, such as fluid electrolyte and pH balance, blood pressure regulation, excretion of toxins and waste, vitamin D metabolism, and hormonal regulation. Many CKD patients experience hyperkalemia, hyperphosphatemia, chronic metabolic acidosis, bone deterioration, blood pressure abnormalities, and edema. Symptoms experienced may be minimized, and the disease's progression may be slowed through an appropriate diet, which is why medical nutrition therapy is a critical aspect of the medical intervention for CKD. The current KDOQI recommendations are proposed as well as the physiological mechanisms behind the recommendations. Current biological explanations of the effects of a whole foods plant-based diet are included for possible contrast with the current renal diet. Strong evidence continues to support the importance of proper nutrition in the prevention and progression of kidney disease.

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Hyperkalemia in chronic kidney disease

Cited by 37 publications

References 31 publications

The cost-effectiveness of government actions to reduce sodium intake through salt substitutes in Vietnam

The cost-effectiveness of government actions to reduce sodium intake through salt substitutes in Vietnam

Review of Impact and Handling of Potential Antihypertensive Drug Interactions in Chronic Kidney Disease Patients

Chronic Kidney Disease: Role of Diet for a Reduction in the Severity of the Disease

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