Hyperkalemia from Dietary Supplements

Batra, Vivek; Villgran, Vipin

doi:10.7759/cureus.859

Cited by 6 publications

(5 citation statements)

References 10 publications

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“…Also, no follow up lab investigations like serum electrolytes were carried out during all of this period. Exogenous potassium coming from diet or supplements can cause hyperkalemia, and it is more pronounced in patients with CKD [6], which was also the case with our patient.…”

Section: Discussionsupporting

confidence: 85%

Severe Persistent Hyperkalemia with Electrocardiogram Changes in a Patient with Hyperaldosteronism

Elmoheen

Mishreky

Albeiruti

et al. 2020

Cureus

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A 62-year-old female presented to the emergency department (ED) with fatigue and generalized body weakness for the last three days. Upon arrival, initial ECG showed wide complex tachycardia with sine waves and a heart rate (HR) ranging between 100-170 bpm. She was otherwise vitally stable. The patient had a past medical history of hyperaldosteronism, type 2 diabetes mellitus (DM), chronic kidney disease (CKD) with microalbuminuria, and hypertension. She also had a history of cerebrovascular accident (CVA) and residual left-sided weakness more pronounced in the upper limb. Initial venous blood gas (VBG) analysis showed a potassium level of more than 10 mmol/L, chloride 114 mmol/L, bicarbonate 9 mmol/L, sodium 135 mmol/L, and pH of 7.1. Treatment for hyperkalemia was started immediately with calcium gluconate 1 gm that effectively narrowed her QRS complex and normalized her ECG. Salbutamol nebulization, glucose/insulin infusion, and calcium polystyrene syrup were given. Later, she was started on 100 mg sodium bicarbonate infusion, and Foley's catheter was inserted to follow urine output (UOP) strictly. However, she did not show a decrease in serum potassium levels. Then the patient underwent hemodialysis for two hours. Her first potassium reading after hemodialysis was 5.2 mmol/L. The purpose of this case report is to emphasize the importance of hemodialysis in patients with persistent severe life-threatening hyperkalemia.

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Section: Discussionsupporting

confidence: 85%

Severe Persistent Hyperkalemia with Electrocardiogram Changes in a Patient with Hyperaldosteronism

Elmoheen

Mishreky

Albeiruti

et al. 2020

Cureus

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“…This is mainly due to these patients’ poor excretory function, leading to the accumulation of toxic herbal remedies. Volume overload and hyperkalaemia are other important considerations of herbal medicine in ESKD [ 22 ]. The loss of excretory functions in patients with ESKD may compound the toxic effects of certain herbal medicines [ 16 ], which might not be safe and cause harm to the patients.…”

Section: Introductionmentioning

confidence: 99%

Traditional and complementary medicine use among chronic haemodialysis patients: a nationwide cross-sectional study

Zakaria

Noor

Abdullah³

2021

BMC Complement Med Ther

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Background In the era of digital and improved conventional medicine, many continue to use traditional and complementary medicine (TCM). The prevalence of its usage is not well reported, especially in patients with end-stage kidney disease (ESKD) receiving haemodialysis, thus its benefits and adverse effects are not widely known. This study determines the prevalence, types, perceptions and factors associated with TCM use by chronic haemodialysis patients in Malaysia. Methods This is a multi-centre cross-sectional study involving patients undergoing haemodialysis treatment in Malaysia. A validated face-to-face questionnaire-based interview was conducted. Sociodemographic and clinical profiles of the patients, factors associated with TCM use, perceptions, sources of information, and disclosures to treating doctors were obtained. Data were analysed using SPSS software. Results A total of n = 329 participants were recruited. The mean age of the participants was 54.9 ± 12.5 years. The majority were Malays (72%) and females (54.7%). A total of 64.7% (n = 213) reported TCM use; n = 132 used TCM before the initiation of dialysis, while n = 81 used TCM after initiation. In the post-hoc analysis, patients who had never used TCM had a higher mean age (56.7 ± 12.3 years) than the patients who used TCM (51.1 ± 13.1) (p = 0.015) and were likely to have received primary education (p = 0.011). Unemployment was more likely to be associated with non-TCM use; with odds ratio 1.85 (95% CI: 1.15, 2.98). Biologically based therapy was found to be the most popular (97.2%) type of TCM, including herbal medicine (67.6%) and supplements (58.0%). Most respondents did not disclose their TCM use to their doctors (72.3%), and 41.8% had the perception that they felt better. Conclusions TCM is widely used among chronic haemodialysis patients in Malaysia, mainly herbal medicine and supplements. Non-disclosure to healthcare professionals and a poor monitoring and regulation of its use in ESKD patients could be detrimental. Awareness needs to be raised among healthcare professionals and the general population. Trial registration The Ethics Committee for Research, University Putra Malaysia (13th March 2019). Reference: UPM/TNCPI/RMC/1.4.18.2 (JKEUPM).

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“…2,6 As a dietary cause, salt substitutes are a well-known source of potassium. 3 This case presents an entirely new class of food, sugar-free items, as a causative factor for hyperkalemia. It also includes a unique case of self-temporizing potassium normalization with increased excretion due to the patient's consumption of sugar-free candies until his abrupt discontinuation in favor of the original versions made with real sugar.…”

Section: Discussionmentioning

confidence: 96%

Unsuspecting Dietary Factors in Hyperkalemia: A Case Report on Why History Matters

McLendon

Wiggins²,

Hunt³

et al. 2020

Clinical Practice and Cases in Emergency Medicine

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Introduction: We present a case of hyperkalemia secondary to excessive dietary intake of hard caramel candies. Case Report: An 88-year-old male who presented with acute abdominal pain and vomiting was found to have hyperkalemia of 6.9 milliequivalents per liter. He was stabilized, treated, and discharged the following day after resolution. The cause was identified as his daily consumption of 200 hard caramel candies. Discussion: The patient had been consuming sugar-free candies, which induced a chronic diarrhea. This led to potassium wasting and augmentation of his home medications. When he transitioned to eating regular caramel candies, he retained too much potassium leading to his presentation. Conclusion: While often overlooked, dietary history is a crucial part of history-taking to ensure that the underlying cause for illness is discovered and addressed.

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Hyperkalemia from Dietary Supplements

Cited by 6 publications

References 10 publications

Severe Persistent Hyperkalemia with Electrocardiogram Changes in a Patient with Hyperaldosteronism

Severe Persistent Hyperkalemia with Electrocardiogram Changes in a Patient with Hyperaldosteronism

Traditional and complementary medicine use among chronic haemodialysis patients: a nationwide cross-sectional study

Unsuspecting Dietary Factors in Hyperkalemia: A Case Report on Why History Matters

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