| Title |
Emergency management of severe hyperkalemia: Guideline for best practice and opportunities for the future
|
|---|---|
| Published in |
Pharmacological Research, September 2016
|
| DOI | 10.1016/j.phrs.2016.09.039 |
| Pubmed ID | |
| Authors |
Patrick Rossignol, Matthieu Legrand, Mikhail Kosiborod, Steven M. Hollenberg, W. Frank Peacock, Michael Emmett, Murray Epstein, Csaba P. Kovesdy, Mehmet Birhan Yilmaz, Wendy Gattis Stough, Etienne Gayat, Bertram Pitt, Faiez Zannad, Alexandre Mebazaa |
| Abstract |
Hyperkalemia is a common electrolyte disorder, especially in chronic kidney disease, diabetes mellitus, or heart failure. Hyperkalemia can lead to potentially fatal cardiac dysrhythmias, and it is associated with increased mortality. Determining whether emergency therapy is warranted is largely based on subjective clinical judgment. The Investigator Network Initiative Cardiovascular and Renal Clinical Trialists (INI-CRCT) aimed to evaluate the current knowledge pertaining to the emergency treatment of hyperkalemia. The INI-CRCT developed a treatment algorithm reflecting expert opinion of best practices in the context of current evidence, identified gaps in knowledge, and set priorities for future research. We searched PubMed (to August 4, 2015) for consensus guidelines, reviews, randomized clinical trials, and observational studies, limited to English language but not by publication date. Treatment approaches are based on small studies, anecdotal experience, and traditional practice patterns. The safety and real-world effectiveness of standard therapies remain unproven. Prospective research is needed and should include studies to better characterize the population, define the serum potassium thresholds where life-threatening arrhythmias are imminent, assess the potassium and electrocardiogram response to standard interventions. Randomized, controlled trials are needed to test the safety and efficacy of new potassium binders for the emergency treatment of severe hyperkalemia in hemodynamically stable patients. Existing emergency treatments for severe hyperkalemia are not supported by a compelling body of evidence, and they are used inconsistently across institutions, with potentially significant associated side effects. Further research is needed to fill knowledge gaps, and definitive clinical trials are needed to better define optimal management strategies, and ultimately to improve outcomes in these patients. |
X Demographics
The data shown below were collected from the profiles of 33 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United States | 7 | 21% |
| Mexico | 4 | 12% |
| Ecuador | 2 | 6% |
| Senegal | 1 | 3% |
| Chile | 1 | 3% |
| Egypt | 1 | 3% |
| France | 1 | 3% |
| India | 1 | 3% |
| Canada | 1 | 3% |
| Other | 1 | 3% |
| Unknown | 13 | 39% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 22 | 67% |
| Scientists | 6 | 18% |
| Practitioners (doctors, other healthcare professionals) | 5 | 15% |
Mendeley readers
The data shown below were compiled from readership statistics for 157 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 157 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Other | 18 | 11% |
| Student > Master | 17 | 11% |
| Student > Bachelor | 16 | 10% |
| Researcher | 14 | 9% |
| Student > Postgraduate | 13 | 8% |
| Other | 28 | 18% |
| Unknown | 51 | 32% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 67 | 43% |
| Pharmacology, Toxicology and Pharmaceutical Science | 9 | 6% |
| Nursing and Health Professions | 5 | 3% |
| Veterinary Science and Veterinary Medicine | 3 | 2% |
| Engineering | 3 | 2% |
| Other | 16 | 10% |
| Unknown | 54 | 34% |
Attention Score in Context
This research output has an Altmetric Attention Score of 18. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 07 August 2019.
All research outputs
#2,017,681
of 25,371,288 outputs
Outputs from Pharmacological Research
#223
of 3,503 outputs
Outputs of similar age
#34,554
of 330,404 outputs
Outputs of similar age from Pharmacological Research
#4
of 53 outputs
Altmetric has tracked 25,371,288 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 92nd percentile: it's in the top 10% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 3,503 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 10.9. This one has done particularly well, scoring higher than 93% of its peers.
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We're also able to compare this research output to 53 others from the same source and published within six weeks on either side of this one. This one has done particularly well, scoring higher than 92% of its contemporaries.