Do beta-blockers increase serum potassium?
A moderate increase in serum potassium concentrations has been observed in several controlled clinical trials with beta-blockers.
How does aldosterone cause hyperkalemia?
A major function of aldosterone is to increase urinary potassium secretion. As a result, hypoaldosteronism can be associated with hyperkalemia and mild metabolic acidosis [1,2]. Sodium wasting is a variable feature of this disorder.
How does potassium shift into hyperkalemia?
Hyperkalemia can result from increased potassium intake, decreased potassium excretion, or a shift of potassium from the intracellular to the extracellular space. The most common causes involve decreased excretion. Alone, excessive intake or an extracellular shift is distinctly uncommon.
How do beta-agonists cause hypokalemia?
[9] Beta-2 agonists have been shown to decrease serum potassium levels via an inward shift of potassium into the cells due to an effect on the membrane-bound Na/K-ATPase, which can potentially result in hypokalemia. Beta-2 agonists also promote glycogenolysis, which can lead to inadvertent elevations in serum glucose.
What is the pathophysiology of hyperkalemia?
In severe hyperkalemia, voltage-dependent inactivation of Nav1.5 channels and activation of inwardly rectifying potassium channels (Kir) lead to reductions in conduction velocity and can render cells refractory to excitation. This manifests as broadening of ECG complexes and/or conduction blocks.
Are the risks of hyperkalemia augmented during the interdialytic gap?
In hemodialysis, the risks of hyperkalemia may be augmented during the long interdialytic gap.
How is hyperkalemia caused by aldosterone synthesis?
The normal physiological response to volume depletion drives upregulation of aldosterone synthesis, so that any reductions in (i)–(iii) are offset by increases in (iv), maintaining potassium homoeostasis. Hyperkalemia ensues when this response is prevented, for example, by renin–angiotensin system (RAS) inhibitors or MR blockers.
What is the Secret Re-Agent of bicarbonate therapy during hyperkalemia?
Calcium salt during hyperkalemia. Kidney Int2016; 90: 451–452 [PubMed] [Google Scholar] 69. Robert T, Burbach M, Joseph A et al.. Sodium is the secret re-agent of bicarbonate therapy during hyperkalemia. Kidney Int2016; 90: 450–451 [PubMed] [Google Scholar] 70.