Fludrocortisone for Heparin-Induced Hyperkalemia

Brown, Glen

doi:10.4212/cjhp.v64i6.1091

Cited by 6 publications

(7 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…82,83 This therapy has enjoyed some recent resurgence, with several reports demonstrating successful treatment of hyperkalemia due to a range of causes. [84][85][86] However, small randomized placebo-controlled trials using oral fludrocortisone in patients on hemodialysis with hyperkalemia have demonstrated poor efficacy 87 or modest efficacy 88 at lowering serum potassium. It is important to note that the doses used in these trials were relatively low (0.1 mg fludrocortisone daily), and older data indicate that patients with renal disease require much higher doses (up to 1.0 mg daily) to effectively reverse hyperkalemia.…”

Section: Treatment Of Hyperkalemiamentioning

confidence: 99%

How Dangerous Is Hyperkalemia?

Montford

Linas

2017

JASN

164

131

View full text Add to dashboard Cite

Hyperkalemia is a potentially life-threatening electrolyte disorder appreciated with greater frequency in patients with renal disease, heart failure, and with use of certain medications such as renin angiotensin aldosterone inhibitors. The traditional views that hyperkalemia can be reliably diagnosed by electrocardiogram and that particular levels of hyperkalemia confer cardiotoxic risk have been challenged by several reports of patients with atypic presentations. Epidemiologic data demonstrate strong associations of morbidity and mortality in patients with hyperkalemia but these associations appear disconnected in certain patient populations and in differing clinical presentations. Physiologic adaptation, structural cardiac disease, medication use, and degree of concurrent illness might predispose certain patients presenting with hyperkalemia to a lower or higher threshold for toxicity. These factors are often overlooked; yet data suggest that the clinical context in which hyperkalemia develops is at least as important as the degree of hyperkalemia is in determining patient outcome. This review summarizes the clinical data linking hyperkalemia with poor outcomes and discusses how the efficacy of certain treatments might depend on the clinical presentation.

show abstract

Section: Treatment Of Hyperkalemiamentioning

confidence: 99%

How Dangerous Is Hyperkalemia?

Montford

Linas

2017

JASN

164

131

View full text Add to dashboard Cite

show abstract

“…Hyperkalemia has been reported as an uncommon adverse effect in humans treated with heparin . Hyperkalemia has been attributed to transient suppression of aldosterone synthesis that resolves with cessation of heparin administration .…”

Section: Case Summarymentioning

confidence: 99%

“…Fludrocortisone, a steroid with potent mineralocorticoid activity, was used to promote potassium excretion and sodium retention . This drug has been used previously in human patients with HIH, resulting in rapid correction of hyperkalemia .…”

Section: Case Summarymentioning

confidence: 99%

Heparin‐Induced Hyperkalemia in a Dog Receiving Continuous Renal Replacement Treatment

Geesaman

Bach

Monaghan³

2015

Veterinary Internal Medicne

View full text Add to dashboard Cite

“…An increase in transtubular potassium gradient response 4 h after administration of fludrocortisone was indicative of the response of our patient to therapy. We speculate that this inhibition of renal potassium excretion in our patient is analogous to heparin‐induced hyperkalaemia, which is thought to be attributable to suppression of aldosterone synthesis through a reduction in the number and affinity of angiotensin II receptors in the adrenal zona glomerulosa . This process may dampen the stimulation by the renin‐angiotensin system of retention of sodium and excretion of potassium.…”

Section: Discussionmentioning

confidence: 64%