Dka Hyperkalemia Or Hypokalemia

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Hyperkalemia In Heart Failure Patients: Current Challenges And Future Prospects

Authors López Vilella R, Morillas Climent H, Plaza López D, Cebrián Pinar M, Sánchez Lázaro I, Almenar Bonet L Accepted for publication 2 December 2015 Checked for plagiarism Yes Peer reviewer comments 2 Raquel López-Vilella, Herminio Morillas-Climent, Diego Plaza-López, Mónica Cebrián-Pinar, Ignacio Sánchez-Lázaro, Luis Almenar-Bonet Heart Failure and Heart Transplant Unit, Cardiology Department, Hospital La Fe, Valencia, Spain Abstract: In heart failure (HF), hyperkalemia is a frequent problem because of several factors, such as neurohormonal mechanisms involved in the disease, renal failure, comorbidities, and drugs with a prognostic benefit. These drugs can block the renin–angiotensin–aldosterone system, and therefore, serum potassium levels can increase, mostly when combined with other drugs as nonsteroidal anti-inflammatories, digitalis, heparin, etc. Hyperkalemia can have severe consequences if not corrected, mostly at the cardiac level (decrease in speed conduction, QRS enlargement, ventricular arrhythmias, and asystole). Therefore, it is important to adequately prescribe these potentially harmful drugs (starting at low doses with close monitoring of renal fu Continue reading >>

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Popular Questions

  1. megan

    I recently got the flu and was feeling awful with a temperature and all the fun that comes with it!. I knew I had to keep eating and taking in fluids though. I could barely get out of bed but I did what I had to. On the 3rd day in the night I checked and found I had high levels of ketones in my urine but in my blood it was 0.9. I checked again a little while later and it was 1.1 in my blood. Then 1.4. My sugars weren't too bad. As the ketones were rising and it was getting later I was worried at what point I would need help. The rule of thumb being getting advice at 1.5 and above and if higher and vomiting then going to A & E.
    I rang 111 as I didn't have anywhere else I could ring at that time. Then a paramedic phoned back to chat. She felt a dr was needed. A dr came round and said Id done the right thing. He found I had a UTI so prescribed antibiotics straight away.
    I was in a state but he said the ketones didn't concern him at this point particularly as they'd come down a bit since he arrived. Down to 1.1.
    He was very kind.
    I have since been in touch with my diabetic nurse during work hours and we have an appointment soon. She told me to check my pump Manual for sick days. I did and can't find any mention of ketones with normal blood sugars.
    She told me the treatment is the same. Go to hospital, get put on a glucose drip and double the insulin.
    We are 3 weeks on and I still have the tail end if this horrible flu virus thing. I live with ME and fibromyalgia too.
    I would rather avoid hospital at all costs. Last time I went in years ago for unrelated reasons I had to get my own blankets and meds back to deal with myself. I prefer to feel in some semblance of control in my own home than relying on others.
    What I'd like to know is others experiences and knowledge. Thanks

  2. ME_Valentijn

    megan said: ↑
    My sugars weren't too bad. What's not too bad? Hyperglycemia can result in excess ketone production starting at 13.3.
    There can be a fairly big delay between hyperglycemia and urine ketones ... maybe there's a similar delay with blood ketones? I had an 18.5 spike during the afternoon while at the GP's office with only "small" amounts of ketones in my urine, but measured "large" amounts of ketones in the evening when my blood sugar was already down to 10-11.
    Maybe you missed a spike in your blood sugar, but caught the after-effects in your ketones?
    megan said: ↑
    We are 3 weeks on and I still have the tail end if this horrible flu virus thing. I live with ME and fibromyalgia too.
    I would rather avoid hospital at all costs. Last time I went in years ago for unrelated reasons I had to get my own blankets and meds back to deal with myself. I prefer to feel in some semblance of control in my own home than relying on others. I have ME/CFS too, and totally understand where you're coming from. I stayed home with a likely case of lactic acidosis induced by metformin, because I felt way too sick to deal with calling anyone or going anywhere, much less a hospital. Probably wasn't thinking too clearly either, due to the severe acid-frying-my-brain headache that came with it
    But the noise, the lights, the food, uncomfortable beds ... it would be torture.

  3. megan

    My bloods were between 5 and 11... got to 13 at one point but I also didn't want to go hypo when I was sick at one point. I got very shaky and weak and hot.... I always got told that blood ketone testing was what was going on currently so more correct where as urine test was hours behind .
    There doesn't seem to be much information about this

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