Mean Potassium Concentrations Research Articles

Temperature and nutrients control the presence and distribution of long-chain diols in Swiss lakes

Long-chain diols are biomarkers commonly used in the marine realm to reconstruct several environmental parameters such as sea surface temperature and salinity. However, they are also produced in lacustrine and slow-flowing river environments, a characteristic that has proved to be useful to trace past riverine inputs in coastal sedimentary records. So far, their use in lacustrine settings is sparse as their controls are not well-known. Previous studies in two lakes have shown that long-chain diol distribution is linked to changes in temperature (in a small Spanish alpine lake), but also to water column stratification (in a large deep Swiss lake). To understand the controls on i) the presence of long-chain diols in lakes, and ii) the distribution of long-chain diol isomers, surface sediments from 52 Swiss lakes were studied. Long-chain diols are present in 57% of the lakes, and machine learning (i.e., random forest model) showed that their presence is mainly controlled by mean annual air temperature, sodium and potassium concentrations and area of the lakes. Long-chain diol isomer relative distribution seems to react to temperature, nutrient (here nitrate) and oxygen concentrations in the lakes. This new insight was tested on a short sedimentary core from Lake Zurich, and compared with other biomarker proxies (based on branched and isoprenoid glycerol dialkyl glycerol tetraethers), as well as with historical record of nutrient contents and temperature. Variations in the long-chain diol index (LDI) mirror measured temperature, but also reacted to changes in nutrients and oxygenation in the lake. This study highlights the potential of long-chain diols as a proxy to trace both nutrients and temperature in lakes, potentially on geological timescales.

Hydrochemical properties of groundwater and land use and land cover changes impact on agricultural productivity: An empirical observation and integrated framework approaches

Land use and land cover (LULC) dynamics of the Bankura district effect groundwater resources and agricultural productivity, particularly the expansion of urban land, discharge of fertiliser mixed water from agriculture and reduction of scrubland. This study investigates the Spatio-temporal relation between groundwater qualities (GWQ), LULC and agricultural productivity of the Bankura district in 2009 and 2020. The twelve standard water qualities parameters; “pH, electrical conductivity (EC), calcium (Ca2+), magnesium (Mg2+), sodium (Na+), potassium (K+), iron (Fe3+), bicarbonate (HCO3¯), chloride (Cl−), sulfate (SO42−), nitrate (NO3−), and fluoride (F−)” were considered for the study. Landsat-5, 7 and 8 images were classified for 2009 and 2020 to detect LULC dynamics related to GWQ. The results showed that GWQ was depleted in 2020 compared to 2009, with agricultural land suffering from lower GWQ than other land uses. Some of the water quality indices (Mean value of pH, EC, Ca2+, Mg2+, and NO3−) drastically declined in 2020 compared to 2009. The degree of contamination (CD) analysis showed the above value of zero (>CD) is highly vulnerable for dug well users. The mean nitrate (7.281 to 51.387 mg/l), calcium (38.366 to 58.082 mg/l), chloride (121.861 to 125.981 mg/l), and potassium (15.261 to 18.363 mg/l) concentration levels drastically increase over the agricultural land. To know the relationship between LULC and agriculture productivity, block-wise production and yield analysis of both years have been presented. It was seen that there are low crop and high productivity observed from the 2009 to 2015 block of Bankura. The overall result indicates that human activities are the primary cause of spatial-temporal changes in GWQ and agricultural productivity. The geospatial-based water quality assessment benefited in understanding changes in GWQ and developing appropriate site-specific agricultural and health policies.

699 HYPERKALIEMIA, USE OF DRUGS TARGETING THE RENIN-ANGIOTENSIN-ALDOSTERONE SYSTEM AND MORTALITY IN PATIENTS FOLLOWED AT A TERTIARY CENTER

Abstract Background Hyperkalemia (HK) has been related to increased mortality in patients with heart failure (HF), at least in part because it leads to down-titration or interruption of renin angiotensin system inhibitors (RASi) and mineralocorticoid receptor antagonists (MRA). Methods We reviewed the records of the HF outpatients with ≥2 visits at our clinic between 2014 and 2021 and complete data on therapy, and identified those who had HK at any time after the first visit. The characteristics between these subjects and those without HK were compared by chi-square test, T-test, or Mann-Whitney test. The use of RASi, MRA and beta-blockers at multiple time points was examined by chi-square or Fisher exact test, and the mean dose for each drug class, expressed as percentage of the guideline-recommended dose, by Wilcoxon rank sum test. The trend of RASi dose over time in HK vs no-HK was assessed by two-way ordinal regression analysis, and the association of HK with all-cause death by Kaplan-Meier method and Cox regression analysis. Results 110 of 690 patients (15.9%) had HK, with the mean potassium concentration being 5.6 mEq/L. Subjects with HK were older [73 (66-79) vs 68 (58-78) years, p<0.001], had more often diabetes (42% vs 27%, p=0.002) and LVEF <40% (77% vs 67%, p=0.03), and had higher creatinine [1.3 (1-1.8) vs 1.1 (0.9-1.3) mg/dL, p<0.001], potassium [4.6 (4.2-5.2) vs 4.2 (3.9-4.5) mEq/L, p<0.001], and NT-proBNP levels [6,480 (2,110-11,000) vs 2,900 (1,115-6,070)], p=0.003] than those without HK. The distribution of RASi, MRA, and beta-blocker was comparable between the two groups at baseline and during follow-up, with the exception of a transient reduction in an early phase (panel A). The mean dose of RASi did not vary significantly between groups and over time (group/timepoint interaction p=0.27; panel B). HK was not associated with all-cause death (panel C; hazard ratio 1.05, 95% confidence interval 0.72–1.52). A sensitivity analysis limited to patients with LVEF <40% yielded similar results (not shown). Conclusions The negative impact of HK on RASi and MRA prescription and on prognosis may be mitigated in tertiary centers with expertise in HF treatment.

Potassium Concentrations in Transgender Women Using Spironolactone: A Retrospective Chart Review

ObjectiveTo assess the incidence of hyperkalemia in transgender women using spironolactone. MethodsThis was a retrospective chart review of transgender women who received gender-affirming hormone therapy that included spironolactone between January 2000 and September 2018. Forty-four participants who had paired potassium concentrations documented and were on spironolactone were included and analyzed. Study outcomes included the incidence of hyperkalemia (serum potassium concentrations > 5.0 mmol/L), the relationship between the duration of treatment and degree of hyperkalemia, and difference between serum potassium concentrations at the beginning of spironolactone treatment versus last serum potassium concentrations. ResultsThe median age of the participants was 36.5 years. The cohort was predominantly non-Hispanic White (32/44). No serum potassium concentration was >5.5 mmol/L, and all participants had serum creatinine level of <2 mg/dL. Median duration of treatment was 25 months (range 2-92 months) and 140 potassium measurements were available. The mean potassium concentration (3.87 mmol/L) before the initiation of spironolactone was lower than the mean potassium concentration (4.03 mmol/L) while on spironolactone (mean difference, 0.16 mmol/L, P = .013). The regression β, that is, the average change in potassium concentration per 1 additional month of treatment duration, was −.001 (95% CI [−.004, .001]; P = .255) signifying no relation between treatment duration and spironolactone use. ConclusionNo participant had laboratory evidence of significant hyperkalemia (K > 5.5 mmol/L) after initiation of spironolactone. Frequent measurement of potassium concentrations might be unnecessary in transgender women taking spironolactone in patients with serum creatinine levels of <2 mg/dL.

Association of Cord Blood Glucose, Sodium, Potassium, and Calcium Levels With Neonatal Birth Asphyxia: A Hospital-Based Study.

ContextNeonatal birth/perinatal asphyxia is a serious condition with the potential to cause damage to various tissues of the body especially the brain. Hypoxia can cause metabolic disturbances, which in turn can lead to imbalances in the levels of glucose, electrolytes, and calcium, which can further worsen the condition. Early detection of these biochemical derangements and immediate correction can prevent the complications and lifelong disabilities of birth asphyxia due to injury to vital organs particularly the brain. The aim is to assess any correlation between the cord blood glucose, electrolytes, and calcium levels and the severity of birth asphyxia.Methods and materialIn this study, 50 birth asphyxia neonates with birth weight >2.5 kg, and a 5-minute Apgar score ≤ 6 at birth with clinical evidence of asphyxia were compared with healthy neonates with birth weight > 2.5 kg, and a 5-minute Apgar score > 7. In all the cases and controls, cord blood glucose was estimated by glucose oxidase and peroxidase (GOD-POD) method, total calcium by Arsenazo method, and sodium and potassium were estimated by ion-selective Electrode (ISE) method using fully automated biochemistry analyzers.ResultsThe mean cord blood concentrations of glucose, sodium, potassium, and calcium were significantly lower among birth asphyxia neonates in comparison with that of controls (p < 0.05). The correlation coefficient (r) for the study variables among cases indicates that there is a low to moderate positive correlation between the 5-minute Apgar score which is a measure of severity of birth asphyxia and cord blood concentrations of glucose, sodium, and calcium.ConclusionIn our study, birth asphyxiated neonates were found to have statistically significant low levels of cord blood glucose and electrolytes like sodium and calcium except for potassium. There was a low to moderate positive correlation between cord blood glucose and electrolyte concentrations with the severity of birth asphyxia. Analysis of cord blood for these simple biochemical tests can help pediatricians in the active management of birth asphyxia cases.

Does Turbulent-Flow Conditioning of Irrigation Water Influence Soil Chemical Processes: I. Laboratory Results

ABSTRACT Researchers commonly assume that the intrinsic behavior of molecular water is invariable, yet accumulating evidence suggests that water behavior can be modified via non-chemical means, e.g. by magnetic field effects. This laboratory study examined the effect of turbulent-flow conditioning (CTap) of a mineralized irrigation water source (Tap water) on water chemistry and the behavior and character of soil–water interactions. Turbulent conditioning did not alter the chemistry of water itself; dissolved organic and inorganic carbon, nitrate, ammonium, chloride, dissolved oxygen, and nutrient element concentrations were the same both before and after treatment. However, turbulent conditioning slightly reduced the surface tension of CTap water relative to Tap. Results indicate that CTap irrigation water changed the chemical composition in one pore volume of water leached through the soil column; consistently increasing mean potassium, ammonium, magnesium, and calcium concentrations by 1.2- to 1.4-fold compared to untreated Tap water. Results for the micro-nutrients were inconclusive because their concentrations in the waters were below the analytical detection limit. Conditioning may have changed physical properties of the CTap water, which altered the nature of its physical and/or chemical interactions with the soil. A consistent effect develops after incubated soil is irrigated for >4-weeks, suggesting that the treatment impacts on soil properties may accumulate over time, potentially influencing soil productivity and management. This phenomenon deserves to be further investigated; if the capacity of this simple device to increase soil cation leaching can be confirmed, it could potentially provide an economical means of managing salt-affected soils.

Biochemical blood profile in 20 female veiled chameleons (Chamaeleo calyptratus) Aged 7, 9 and 11 Months

Veiled chameleons ( Chamaeleo calyptratus ) are more frequently presented to veterinary clinics due to reproductive diseases that lead to high morbidity, especially in captive-bred females. The objective of this study was to evaluate blood biochemical profiles of healthy, young captive females veiled chameleons aged seven, nine and eleven months. Blood samples were taken from 20 female veiled chameleons at the age of 7, 9 and 11 months. The biochemical profile was analyzed using the VetScan VS2 analyzer with an Avian/Reptile Profile rotor. The ionized calcium (iCa) concentration was measured by i-STAT analyzer with a CHEM+8 cartridge. Mean concentration of glucose (15.8 ± 1.3 mmol/l) and uric acid (244.3 ± 143.2 µmol/l) at the age of seven months were significantly higher than mean concentrations of glucose (12.8 ± 16.5 mmol/l) and uric acid (134.9 ± 113.2 µmol/l) at nine months of age and mean concentration of glucose (13.2 ± 0.9 mmol/l) and uric acid (129.4 ± 109.2 µmol/l) at 11 months of age, respectively. Total calcium (4.2 ± 0.8 mmol/l) and ionized calcium (1.51 ± 0.16 mmol/l) were significantly higher at seven months of age compare to nin months. Mean activity of aspartate aminotransferase at nine months (6.2 ± 2.3 µkat/l) was significantly higher (P=0.004) than the mean activity of aspartate aminotransferase at seven months of age (4.7 ± 1.0 µkat/l). Concentrations of potassium at eleven months (8.3 ± 2.1 mmol/l) were significantly higher ( P ˂ 0.001) than the mean concentration of potassium at seven months (5.4 ± 1.3 mmol/l) and also at ninth months (6.1 ± 1.6 mmol/l). No significant differences were found among the mean concentrations of total protein (57.5 ± 14.6, 61.9 ± 9.2, 59.6 ± 12.2 g/l), albumin (32.8 ± 5.4, 33.6 ± 4.1, 33.4 ± 7.1 g/l), globulin (27.4 ± 5.4, 26.6 ± 4.3, 26.3 ± 5.4 g/l) and mean activity of creatine kinase (25.4 ± 10.3, 30.1 ± 21.0, 25.6 ±13.2 µkat/l) at any of the ages. In all females, ovarian activity was already evident in the first part of monitoring, and the measured values could be interpreted as values for young female veiled chameleons during active ovarian activity.

Measuring potassium level in packed red blood cells before using: Word of caution for congenital cardiac surgery.

Transfusion-associated hyperpotassemia is a serious complication of packed red blood cell (PRBC) transfusion after congenital cardiac surgery. Our study aimed to identify risk factors and potential preventive measures of transfusion-associated hyperpotassemia in neonates and infants after congenital cardiac surgery. Pediatric patients who underwent congenital cardiac surgery and need transfusion were enrolled in this prospective study. The potassium concentration of PRBC was checked from the sample taken from the segment. The volume of transfusion, age of PRBC, potassium concentration of unit were recorded. The estimated increment of potassium level in patients after PRBC transfusion was calculated. Seventy-four individual patients, 95 distinct transfusions, 112 blood products were evaluated. The mean age of the blood unit was 3.8 ± 1.4 days. The mean potassium concentration in the PRBCs was 9.9 ± 2.4 mmol/L. A weak correlation was observed between the potassium value of the PRBC and the age of PRBC (p = 0.049, r = 0.2, y = 0.24 × x + -0.68). There was a weak correlation between the potassium value of PRBCs and the age of the unit (p < 0.001, r = 0.37, y = 2.8 × x + -3.6). Before transfusion, even PRBC is fresh, measuring the potassium level of PRBC and the potassium that will be given to the pediatric patient with transfusion can prevent transfusion-related hyperpotassemia and related complications. Otherwise, high potassium levels, which may be overlooked despite being fresh, may cause serious complications, even cardiac arrest, especially in neonates and infants.

Chemical Composition of Lick Soils and Functions of Soil Ingested by Common Warthogs (&amp;lt;i&amp;gt;Phacochoerus africanus&amp;lt;/i&amp;gt;) in Dabena Valley Forest, Western Ethiopia

To identify chemical composition of lick soil and function of soil ingested by common warthogs (<i>Phacochoerus africanus</i>), the study was conducted in Gassi Controlled Area (GCHA); southwestern and in Haro Aba Diko Controlled Hunting Area (HADCHA) northeastern Dabena Valley Forest from May 2016 to June 2018. Top soil samples licked by common warthog were taken from 2.5 cm diameter, 20 cm deep soil cores, from five evenly spaced locations around the periphery of the central 60x60 m grid in each feeding plot. Soil samples were dried under shade for one week and then kept at 28°C until analyzed. Samples were homogenized and sieved through 2 mm mesh. The mean proportion of organic carbon in Menjiko (t= 5.21, df=1, P<0.01) and in Gimbicho (t= –4.08, df=1, P<P0.05) revealed significant variation between wet and dry seasons. The mean proportion of total nitrogen was lower in GCHA (0.153 ±0.014) and higher in HADCHA (0.206±0.014) during the dry season. Hence, they showed significant variation (F1, 14= 7.06, P < 0.05) in the amount of total nitrogen. Mean sodium concentration in salt lick, common warthog ingested varied from 0.01 ±0.001Na meq/100g (Menjiko) to 0.08±0.006 meq/100g (Dodeta) during the dry season. However, the study areas were insignificantly different (F1,14=1.63, P > 0.05). Mean potassium concentration in salt lick common warthog ranged from 0.11±0.014 meq/100g (Desa) to 0.246±0.01meq/100g (Robe) during the wet season in Dabena Valley Forest (DVF). Warthogs supplemented their forage intake by licking different mineral elements from the ground. Mineral lick also benefits the animals in regulating the state body equilibrium and defending pathogens invading the animal’s body.

Nutrient stocks of Japanese blue oak (Quercus glauca Thunb.) stands on different soil parent materials

Soil parent materials originating from different geologic settings represented broad differences in the forest nutrient environment, but few studies have been conducted on the relationships between soil parent materials and nutrient stocks in forest stands. This study was performed to compare the nutrient stocks of Japanese blue oak (Quercus glauca Thunb.) stands grown on forest soils inherited from two different parent materials, basalt and sandstone, in southern Korea. A total of 29 Japanese blue oak trees were destructively sampled (15 trees on basalt and 14 trees on sandstone) to compare the nutrient content of the tree components (stem wood, stem bark, branches, and leaves). Samples of the forest floor and a soil depth of 0–30 cm were collected to measure the nutrient stocks of the two parent materials. The mean nutrient concentrations of the tree components varied significantly between the basalt and sandstone parent materials. The mean carbon and potassium concentrations of stem wood were significantly higher in sandstone than in basalt, whereas the nitrogen concentration of stem wood and stem bark were lower in sandstone than in basalt (p < .05). A significantly higher carbon, nitrogen, potassium, and magnesium stocks of the forest floor were found in sandstone than in basalt. However, the soil carbon, nitrogen, calcium, and magnesium stocks at a depth of 0–30 cm were significantly higher in basalt than in sandstone. The results demonstrate that the aboveground nutrient concentration and belowground nutrient stocks of Japanese blue oak stands can be altered greatly by different parent materials.

Validation of a database of mean uranium, thorium and potassium concentrations in rock samples of Portuguese geological units, generated of literature data

The European Atlas of Natural Radiation, recently published, contains a collection of maps of Europe showing the levels of natural sources of radiation. Among the lacunae of the Atlas are maps of U, Th and K concentrations in rocks due to lack of European-wide geochemical surveys of bedrock units. The objective of this paper is to investigate the usability of scattered geochemical data of rock samples for large-scale mapping of U, Th and K concentrations in geological units. For this purpose, geochemical data were compiled from literature sources to produce a geochemical database (LIT database) that includes 2817 entries of U, Th and K concentrations measured in rock samples of geological units outcropping in Portugal.Given the methodical heterogeneity within LIT database, the influence of the geochemical analysis techniques was assessed through a three-way analysis of variance (ANOVA) using geological units, geochemical analysis techniques and loss on ignition (LOI) as categorical variables. The percentage of variation explained by geological factors was large (>35%), while the percentage of variation explained by the geochemical analysis techniques and LOI was generally lower than 5%. The geological factors were the main source of variability in the data, followed by the error component which can be assumed to represent the true spatial variability of geochemical concentrations. The pairwise comparison of the least square (LS) means computed through the ANOVA for each geochemical analysis technique indicates that LIT database can be considered consistent within itself, thus, reliable.In order to validate the usability of literature data the terrestrial gamma dose rate (TGDR) calculated from LIT database (TGDRcalc) was compared to the TGDR displayed in the Radiometric Map of Portugal (TGDRobs). The correlation between TGDRcalc and TGDRobs was highly significant (p < 0.001) and the results of a paired sample t-test and Wilcoxon median tests indicate that the differences between the arithmetic means of TGDRcalc and TGDRobs were not statistically significant (p = 0.126 and p = 0.14, respectively). Distributions of TGDRcalc and TGDRobs were seemingly equal according to the Kolmogorov-Smirnov and Anderson-Darling tests. Although, systematic discrepancies between TGDRcalc and TGDRobs were observed for sedimentary rocks, the compatibility of the RMP and LIT databases can be considered acceptable, which implies that the estimation of the contents of terrestrial radionuclides using literature data for large-scale mapping of U, Th and K contents in geological units is reasonable.

Protective Role of Leptadenia Hastata on the Haematological and Biochemical Alterations in Adrenaline-Induced Hypertensive Rats

Background: Leptadenia hastata (L. Hastata) is a plant used for various diseases in Nigeria. This study evaluated the protective effects of L. hastate on the haematological and biochemical alterations in adrenaline-induced hypertensive rats. Methods: Twenty-five rats were divided equally into five groups (A-E). Groups A-D were given 0.5 mg/kg adrenaline, groups A and B were treated with 100 and 200 mg/kg the extract of L. Hastata, respectively, while groups C and D were treated with 5 mg/kg amlodipine (standard control) and normal saline (untreated control), respectively. Group E were given distilled water (normal controls). The adrenaline was injected intraperitoneally while the extract was given orally once daily for seven days. Results: Treatment with 100 and 200 mg/kg of the extract significantly reduced the elevated serum albumin, ALP, ALT, AST, chloride, sodium and creatinine, cholesterol and LDL concentrations compared with the untreated hypertensive rats. The bicarbonate level, WBC and RBC counts, mean cell hemoglobin and packed cell value were higher in rats treated with the extract compared with the untreated hypertensive rats. The mean cell value, HDL, triglyceride, urea, potassium, total and direct bilirubin concentrations in experimental groups were not significantly different from those in the controls (P&lt;0.05). Conclusion: Our results suggest that treatment of the hypertensive rats with the extract of L. Hastata protects against renal, hepatic and cardiac damages, thus it could be considered as a natural anti-hypertensive agent. Further studies are required to identify the bioactive constituents and the mechanism(s) of action.

Impact of hemodialysis on the concentrations of sodium and potassium during infusion of sodium thiosulfate using an In Vitro hemodialysis model.

IntroductionThe purpose of this study was to evaluate the impact of hemodialysis on the concentrations of sodium and potassium in the blood when a 25 g dose of sodium thiosulfate injection is infused over 60 minutes in combination with hemodialysis.MethodsSodium thiosulfate (25 g) was prepared by diluting 100 mL of 250 mg/mL Sodium Thiosulfate Injection with 800 mL of 5% dextrose. This was added to the circulating blood surrogate solution at a rate of 15 mL/minute using an infusion pump of an in vitro model of dialysis machine. Serial samples were collected before the administration of the sodium thiosulfate solution, after 15 minutes, 30 minutes, and 60 minutes of infusion from pre-and post-dialyzer ports in both the dialysate circuit and the extracorporeal circuit.FindingsThe concentration of sodium thiosulfate in pre-dialyzer and post-dialyzer samples of the circulating blood surrogate solution peaked at 30 minutes and 15 minutes, respectively and then remained relatively unchanged during the remainder of the infusion. Mean sodium concentrations (mEq/L) in the circulating blood surrogate solution collected after exposure to a dialyzer were 103.2 ± 12.2, 114.2 ± 18.8, 117.2 ± 7.5, 93.5 ± 5.9 at 0, 15, 30, and 60 minutes, respectively (p = 0.248). Mean potassium concentrations (mEq/L) in the circulating blood surrogate solution collected after exposure to a dialyzer were 1.4 ± 0.3, 1.6 ± 0.3, 1.5 ± 0.1, 1.2 ± 0.1 at 0, 15, 30, and 60 minutes, respectively (p = 0.365). Sodium and potassium concentrations in dialysate increased marginally after exposure to the dialyzer.DiscussionOur study demonstrates that neither potassium nor sodium accumulated in circulating blood surrogate solution when a dose of sodium thiosulfate was infused in conjunction with hemodialysis.

Association between potassium concentrations, variability and supplementation, and in-hospital mortality in ICU patients: a retrospective analysis

BackgroundSerum potassium concentrations are commonly between 3.5 and 5.0 mmol/l. Standardised protocols for potassium range and supplementation in the ICU are lacking. The purpose of this retrospective analysis of ICU patients was to investigate potassium concentrations, variability and supplementation, and their association with in-hospital mortality.MethodsICU patients ≥ 18 years, with ≥ 2 serum potassium values, treated at the Charité - Universitätsmedizin Berlin between 2006 and 2018 were eligible for inclusion. We categorised into groups of mean potassium concentrations: < 3.0, 3.0–3.5, > 3.5–4.0, > 4.0–4.5, > 4.5–5.0, > 5.0–5.5, > 5.5 mmol/l and potassium variability: 1st, 2nd and ≥ 3rd standard deviation (SD). We analysed the association between the particular groups and in-hospital mortality and performed binary logistic regression analysis. Survival curves were performed according to Kaplan–Meier and tested by Log-Rank. In a subanalysis, the association between potassium supplementation and in-hospital mortality was investigated.ResultsIn 53,248 ICU patients with 1,337,742 potassium values, the lowest mortality (3.7%) was observed in patients with mean potassium concentrations between > 3.5 and 4.0 mmol/l and a low potassium variability within the 1st SD. Binary logistic regression confirmed these results. In a subanalysis of 22,406 ICU patients (ICU admission: 2013–2018), 12,892 (57.5%) received oral and/or intravenous potassium supplementation. Potassium supplementation was associated with an increase in in-hospital mortality in potassium categories from > 3.5 to 4.5 mmol/l and in the 1st, 2nd and ≥ 3rd SD (p < 0.001 each).ConclusionsICU patients may benefit from a target range between 3.5 and 4.0 mmol/l and a minimal potassium variability. Clear potassium target ranges have to be determined. Criteria for widely applied potassium supplementation should be critically discussed.Trial registration German Clinical Trials Register, DRKS00016411. Retrospectively registered 11 January 2019, http://www.drks.de/DRKS00016411

Review of case reports on hyperkalemia induced by dietary intake: not restricted to chronic kidney disease patients.

Hyperkalemia is a metabolic disturbance of the potassium balance that can cause potentially fatal cardiac arrhythmias. Kidney dysfunction and renin-angiotensin-aldosterone system inhibiting drugs are notorious for their tendency to induce hyperkalemia by decreasing the excretion of potassium. The role of dietary potassium intake in inducing hyperkalemia is less clear. We review and analyze the common presentation, laboratory, and electrocardiogram (ECG) findings and therapeutic options associated with dietary-induced hyperkalemia, and find evidence for hyperkalemia development in non-renal impaired patients. Thirty-five case reports including 44 incidences of oral intake-induced hyperkalemia were assessed, 17 patients did not suffer from kidney dysfunction. Mean age was 49 ± 20 years. Mean potassium concentration was 8.2 ± 1.4 mEq/l, most frequently caused by abundant intake of fruit and vegetables (n = 17) or salt substitutes (n = 12). In patients with normal kidney function, intake of salt substitutes or supplements was the main cause of hyperkalemia. Main symptoms encompassed muscle weakness (29.5%), vomiting (20.4%), and dyspnea (15.9%). When ECGs were performed (n = 30), abnormalities were present in 86.7% of cases. Treatment involved administration of insulin (n = 22), sodium/calcium polystyrene sulfonate (n = 14), and/or calcium gluconate (n = 14). Forty patients fully recovered. Three, non-renal impaired, patients passed away. These results offer insight into the clinical aspects of dietary-induced hyperkalemia and suggest that the common assumption that dietary-induced hyperkalemia is a condition of renal impaired patients might be incorrect.

Effects of experimental lead exposure and the therapeutic effect of defatted Moringa oleifera seed meal on serum electrolytes levels of Wistar rats

The study was conducted to evaluate changes in serum electrolytes concentrations following experimental lead acetate (Pb) exposure and the effects of treatment with defatted Moringa oleifera seed meal (DMOSM) in wistar rats. Eighty adult wistar rats divided into 5 groups of 16 per group were used for this study. Rats in group I received only distilled water, group II were administered Pb solution orally at 480 mg/kg body weight, group III were co-administered Pb and DMOSM orally at 480 mg/kg respectively, group IV were pre-administered Pb orally at 480 mg/kg for the first two weeks and then administered DMOSM orally at 480 mg/kg for the subsequent two weeks, group V received DMOSM orally at 480 mg/kg. Four rats were sacrificed weekly from each group and blood samples for serum electrolyte analysis were obtained. Phytochemical screening of DMOSM revealed the presence of alkaloids, reducing sugars, cardiac glycosides and saponins. A significant decrease (P < 0.05) in the mean serum Ca 2+ concentration in the rats in group III (1.52±0.17) was observed at week 3 compared to group IV (2.24±0.16). Mean serum concentration of PO 4 + at week 1 in rats in group III (3.62±0.15) was significantly higher (P < 0.05) compared to group IV (2.89±0.18). Similarly, serum PO 4 + level significantly rose at week 3 in group II (4.40±0.36) compared to rats in groups IV (2.61±0.11) and V (2.99±0.07) respectively. By week 4, the serum PO 4 + concentration rose significantly in the rats in group III (5.47±0.11) compared to those in group I (3.27±0.24). Mean serum concentrations of sodium (Na + ), chloride (Cl - ), potassium (K + ) and bicarbonate (HCO 3 - ) were not significantly altered in all the test groups throughout the duration of the study. The result showed inability of DMOSM to mitigate Pb-induced alteration in serum Ca 2+ and PO 4 + levels in groups II and III. Keywords: Lead, Moringa oleifera, Phytochemical screening, Serum electrolytes, Wistar rats

Association of mineral imbalance with leaf chlorosis under saline irrigation in Sharad seedless grapes raised on Dog Ridge rootstock

Under saline irrigation, development of leaf chlorosis/discoloration beginning from the upper leaves has been found to cause severe reduction in productivity and life span of the Sharad Seedless grape (Vitis vinifera L.) and its mutants grafted on Dog Ridge rootstock. In the present study, mineral accumulation in vine tissues over the years under saline irrigation and association of mineral imbalance with chlorosis/necrosis was investigated during the two pruning seasons in Sharad Seedless vines grafted on Dog Ridge rootstock. The contents of nitrogen, phosphorus, potassium, calcium and magnesium were significantly lower and sodium and chloride contents were found significantly higher in upper leaf lamina of symptomatic vines. Lamina N, P, K and Ca and Mg contents were positively correlated, whereas sodium and chloride contents were negatively correlated with chlorophyll content. Significant negative correlation was observed between chloride and phosphorus and nitrogen concentration in leaf tissues. Principal component analysis revealed a negative interaction between N, P, K and Na and Cl−content in leaf tissues. Principal components (PCs) explained 91.7% of total variation in leaf lamina and were designated as PC1 (N+P+K-Na-Cl) and PC2 (N+P+K+Ca+Mg). Symptomatic vines accumulated higher sodium (>5.0 g−1/kg) than potassium content in the leaf tissues and mean potassium content in symptomatic leaf lamina was <5.0 g−1/kg. Increased accumulation of Na+ and Cl− in the chlorotic leaf tissues revealed that ability of Dog Ridge rootstock to exclude these salts diminished over time and long term studies are needed for identifying salt tolerant rootstocks.

Diurnal variation of urinary sodium-to-potassium ratio in free-living Japanese individuals

High sodium-to-potassium ratios are associated with elevated blood pressure levels and an increased risk of cardiovascular diseases. We aimed to determine whether urinary sodium-to-potassium ratios fluctuate diurnally during the day to understand measured values of casual urinary sodium-to-potassium ratios. A total of 13,277 casual urine specimens were collected under free-living conditions from 122 Japanese normotensive and hypertensive individuals. Participants collected all casual urine samples in aliquot tubes, reported urine volumes and the time at each voiding for 10–22 days. Then, specimens were classified into hourly data. Diurnal patterns of urinary sodium-to-potassium ratios and urinary concentrations of sodium and potassium were evaluated. Overall mean values of hourly urinary sodium-to-potassium ratios were highest (4.1–5.0) in the early morning, lower (3.3–3.8) in the daytime and higher (4.0–4.4) toward evening hours. The mean urinary sodium and potassium concentrations were the lowest (90–110 and 24–32 mmol l−1, respectively) during the early morning and higher (110–140 and 35–43 mmol l−1, respectively) after mid-morning. Diurnal variability of potassium concentrations was larger than for sodium concentrations. Diurnal variations in urinary sodium-to-potassium ratios were comparable between normotensive and hypertensive individuals, between hypertensive individuals with and without antihypertensive medications, and among age and gender-specific subgroups. Overall mean hourly urinary sodium-to-potassium ratios fluctuated diurnally under free-living conditions and were higher during the morning and evening and lower during the daytime compared with 24-h urinary sodium-to-potassium ratios. Diurnal variation in urinary sodium-to-potassium ratios should be considered to understand actual daily dietary levels and avoid over- and under-estimation in clinical practice.

20-Day Trend of Serum Potassium Changes in Bam Earthquake Victims with Crush Syndrome; a Cross-sectional Study.

Many of those who survive following an earthquake die in the next phase due to preventable and treatable medical conditions such as hyperkalemia. The present study aimed to evaluate the trend of potassium changes in crush syndrome patients of Bam earthquake. In this retrospective cross-sectional study, using the database of Bam earthquake victims, which were developed by Iranian Society of Nephrology following Bam earthquake, Iran, 2003, the 20-day trend of potassium changes in > 15 years old crush syndrome patients was evaluated. 135 crush syndrome patients with the mean age of 29.9 ± 9.91 years were evaluated (56.3% male). Mean potassium concentration during the first 3 days of admission was 5.6 ± 1.3 mEq/L. On the day of admission, 43.1% (95% CI: 34.0 - 52.2) had normal potassium concentration, 3.4% (95% CI: 0.1 - 6.8) had hypokalemia, and 53.4% (44.3 - 62.6) had hyperkalemia. During 20-day follow-up, 62.3% (95% CI: 66.7-71.9) of the patients had normal potassium. While, 11.5% (95% CI: 9.7-13.3) had hypokalemia and 19.2% (95% CI: 17.0-21.5) had hyperkalemia. As the days of hospitalization increased, prevalence of hyperkalemia decreased while hypokalemia increased. On the 17th day 21.2% (95% CI: 2.2-39.9) had hypokalemia and 10.5% (95% CI: 0.1 - 24.7) had hyperkalemia. Findings of the present study showed that following urine alkalinization and fluid resuscitation, the prevalence of hyperkalemia reduced, but hypokalemia developed. It seems that the correction of serum potassium level should be accompanied by precise monitoring of intake and output of the patient and prescription of reasonable amount of intravenous fluid.

Sodium and Potassium Content of Meals Served in University Canteens

A high sodium intake is associated with high blood pressure, an important risk factor for noncommunicable diseases (NCDs). In contrast, the ingestion of high levels of potassium counteracts this negative effect of high sodium intake on blood pressure, thus reducing the sodium-to-potassium ratio. The aim of this work was to determine the sodium and potassium content of meals served in university canteens in Portugal. The analysis included 35 samples of soup and 35 samples of main dish collected at 5 random days from a total of 7 university canteens. The samples were analyzed for sodium and potassium by atomic emission spectrometry technique. On average, a meal (soup and main dish) had a sodium content of 1,069.4 mg (mean sodium content was 671.4 ± 374.5 mg/portion in the main dish and 398.0 ± 153.0 mg/portion in the soup) and a potassium content of 1,004 mg (mean potassium content was 731.4 ± 385.9 mg/serving in the main dish and 272.6 ± 272.6 mg/serving in the soup). Our results revealed that with a single university meal, students can reach 53% of the maximum daily value recommended for sodium and 27% of the minimum daily value recommended for potassium. An investment to decrease sodium and increase potassium in meals served is imperative in order to prevent NCDs.