Hyperkalaemia Health Dictionary

Synthetic organic substances, capable of exchanging ions – cationic or anionic – from the contents of the intestine. Originally used in the prevention of OEDEMA, they have been superseded in this role by the modern DIURETICS, and are now used chie?y in the treatment of HYPERKALAEMIA. They are usually taken by mouth or as an ENEMA.... ion exchange resins

The clinical state which results from renal failure (see KIDNEYS, DISEASES OF). It may be due to disease of the KIDNEYS or it may be the result of pre-renal causes where a lack of circulating blood volume inadequately perfuses the kidneys. It may result from acute necrosis in the tubules of the kidney or it may result from obstruction to the out?ow of URINE.

The word uraemia means excess UREA in the blood; however, the symptoms of renal failure are not due to the abnormal amounts of urea circulating, but rather to the electrolyte disturbances (see ELECTROLYTES) and ACIDOSIS which are associated with impaired renal function. The acidosis results from a decreased ability to ?lter hydrogen ions from blood into the glomerular ?uid: the reduced production of ammonia and phosphate means fewer ions capable of combining with the hydrogen ions, so that the total acid elimination is diminished. The fall in glomerular ?ltration also leads to retention of SODIUM and water with resulting OEDEMA, and to retention of POTASSIUM resulting in HYPERKALAEMIA.

The most important causes of uraemia are the primary renal diseases of chronic glomerular nephritis (in?ammation) and chronic PYELONEPHRITIS. It may also result from MALIGNANT HYPERTENSION damaging the kidneys and amyloid disease destroying them. Analgesic abuse can cause tubular necrosis. DIABETES MELLITUS may cause a nephropathy and lead to uraemia, as may MYELOMATOSIS and SYSTEMIC LUPUS ERYTHEMATOSUS (SLE). Polycystic kidneys and renal tuberculosis account for a small proportion of cases.

Symptoms Uraemia is sometimes classed as acute – that is, those cases in which the symptoms develop in a few hours or days – and chronic, including cases in which the symptoms are less marked and last over weeks, months, or years. There is, however, no dividing line between the two, for in the chronic variety, which may be said to consist of the symptoms of chronic glomerulonephritis, an acute attack is liable to come on at any time.

Headache in the front or back of the head, accompanied often by insomnia and daytime drowsiness, is one of the most common symptoms. UNCONSCIOUSNESS of a profound type, which may be accompanied by CONVULSIONS resembling those of EPILEPSY, is the most outstanding feature of an acute attack and is a very dangerous condition.

Still another symptom, which often precedes an acute attack, is severe vomiting without apparent cause. The appetite is always poor, and the onset of diarrhoea is a serious sign.

Treatment The treatment of the chronic type of uraemia includes all the measures which should be taken by a person suffering from chronic glomerulonephritis (see under KIDNEYS, DISEASES OF). An increasing number of these patients, especially the younger ones, are treated with DIALYSIS and/or renal TRANSPLANTATION.... uraemia

(Roxb.) Kunth.

Synonym: Drimia indica Roxb. non-(Wt.) Baker.

Family: Liliaceae.

Habitat: Western Himalayas, Bihar, Konkan and along the Coromandel Coast. U. maritima (L.) Baker is native to Mediterranean region.

English: Indian Squill, Sea Onion (red and white varieties).

Ayurvedic: Vana-palaandu, Kolakanda, Vajrakanda.

Unani: Unsul-e-Hindi, Isqueel- e-Hindi, Piyaaz-Dasti, Piyaaz- Sahraayi, Jangali Piyaaz.

Siddha/Tamil: Narivengayam.

Action: Used as a substitute for European Squill, Urginea maritima. Expectorant (in dry respiratory conditions, whooping cough and bronchial asthma), antispasmodic, emetic (in large doses), diuretic (promotes fluid elimination in heart disease), cardiac tonic (effect, non-cumulative). Used topically as a hair tonic for dandruff and seborrhoea (active constituent is thought to be scilliroside of the Red Squill.)

Key application: Urginea maritima—in milder cases of heart insufficiency, also for diminished kidney capacity. (German Commission E.)

Bulbs contain cardiac glycosides, scillarens A and B. Bulb, leaves and root contain stigmasterol, sitosterol and campesterol. Bulbs also contain hentriacontanol, octacosanoic acid. Defatted air-dried bulbs afforded 6- desacetoxyscillirosidin.

The plant exhibits cyanogenetic activity.

Urginea maritima (White Squill) is contraindicated in potassium deficiency or when digitalis glycosides are being used (Francis Brinker), in hyper- calcaemia and hyperkalaemia (Sharon M. Herr).

Urginea coromandeliana Hook. f. non-Wight, synonym U. wightiana Hook f. (Coromandel coast and in dry regions of Andhra Pradesh and Tamil Nadu up to 3,000 m) is used as a substitute for Indian Squill (U. indica).

Dosage: Bulb—120-200 mg powder. (CCRAS.)... urginea indica

n. the rapid breakdown of skeletal muscle cells, with the release of myoglobin and other potentially toxic cell components. Blood levels of *creatine kinase are raised. It can result in *hyperkalaemia, *hypovolaemia, *myoglobinuric acute renal failure, and *disseminated intravascular coagulation. Causes include muscle trauma and crush injury, alcohol abuse, seizures, and medications (notably statins).... rhabdomyolysis

A mineral needed to help maintain normal heart rhythm, regulate the body’s water balance, conduct nerve impulses, and contract muscles. Dietary sources of potassium include lean meat, whole grains, green leafy vegetables, beans, and various fruits, such as apricots, dates, and peaches.

A low level of potassium in the blood is known as hypokalaemia. It is usually a result of loss of fluids through diarrhoea and/or vomiting, and causes fatigue, drowsiness, dizziness, and muscle weakness. In more severe cases, there may be abnormal heart rhythms and muscle paralysis.

Excess potassium in the blood is known as hyperkalaemia and is much less common than hypokalaemia. It may be due to excessive intake of potassium supplements, severe kidney failure, Addison’s disease, or prolonged treatment with potassium-sparing in a similar way to nitrates, and widens both arteries and veins. Possible side effects include flushing, nausea, vomiting, and dizziness.... potassium

(RTA) metabolic acidosis due to failure of the kidney to excrete acid into the urine. Three types of RTA are recognized. Type 1 (distal RTA) results from a reduction in net acid secretion in the distal convoluted tubule (see nephron) and an inability to acidify the urine. Hypokalaemia is often present and may be severe. The condition can be either genetically determined or, more commonly, the result of systemic disease (e.g. autoimmune disorders) or drugs (e.g. amphotericin). Type II (proximal RTA) is due to a lowered threshold for bicarbonate reabsorption; eventually a steady state is established with a low serum bicarbonate but capacity to acidify the urine. Hypokalaemia is present due to *aldosteronism caused by the increased delivery of sodium to the distal tubule. Proximal RTA usually occurs as part of more widespread proximal tubule dysfunction with the *Fanconi syndrome. Type IV RTA results from impaired excretion of both acid and potassium and results in acidosis with hyperkalaemia. It is most commonly seen with aldosterone deficiency. This may be isolated, especially in diabetics, or it may be induced by drugs (angiotensin II antagonists or ACE inhibitors).... renal tubular acidosis