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Biomedical subjects

G Gercsák

Publications and source records attributed to G Gercsák.

16 recordsLinked to original sources
PubMed1986

Interplay of various factors in glucose-induced hyperkalemia during captopril treatment.

The effect of angiotensin converting enzyme inhibition by captopril (CAP) on serum potassium (SK) changes was studied during a three-hour glucose tolerance test (GTT) in recumbent and upright positions in 16 patients with drug-resistant hypertension. An elevation of SK in the upright posture occurred in the course of GTT during CAP treatment in 50% of the patients (Group I) even without consistent changes in baseline SK. In Group II a qualitatively normal glucose-induced hypokalemic response was obtained. Aldosterone was suppressed by CAP, predominantly in the upright position in Group I due to the significant interaction between the drug and posture. Significant inverse correlations were found in Group I between glucose-induced serum potassium changes and basal glomerular filtration rate. A similar correlation was found also with serum insulin in the whole patient material. It was concluded that the interplay of various factors, CAP, upright posture and impaired renal functions resulting in suppression of aldosterone and insulin played a role in the paradoxical glucose-induced serum potassium elevation.

Adult↗
PubMed1984

Effect of body posture on the serum potassium response to glucose in healthy subjects, diabetics and hyperthyroid patients.

Administration of glucose induces normally a decrease in serum potassium, though exceptionally a paradoxcial increase (PGIH) may occur. The effect of posture on glucose-induced serum potassium changes in health and disease has not been previously studied. We have investigated the influence of changes in body posture on the different serum potassium responses to glucose in various groups of 47 subjects. We have found a smaller decrease in serum potassium in the upright position than in the recumbent one in 20 healthy subjects and in 12 non-insulin dependent diabetics, but no significant difference in hyperthyroidism. The variable effect of posture on glucose-induced insulin secretion in the various groups of subjects did not provide explanation for the postural inhibition of the normal serum potassium response to glucose. A tendency to PGIH was found in a small number of diabetics. Although PGIH was completely reversed by DOC the normal postural difference between serum potassium curves was uneffected. It was concluded that change in the body posture has a definite influence on the glucose-induced decrease in serum potassium in normal people and is not mediated by insulin and/or aldosterone; PGIH develops in the upright position more easily than recumbency; exact serum potassium changes after glucose loading can be explored only by adequate standardization and carrying out both recumbent and upright measurements.

Adult↗
PubMed1982

Glucose-induced hyperkalemia developing in the upright position in captopril-treated hypertensives.

Paradoxical glucose-induced hyperkalemia (GIH) was elicited exclusively in the upright position during captopril treatment in four hypertensive patients (Group 3) without impaired glucose tolerance in three. Inhibited aldosterone production and inappropriate plasma aldosterone responses to increasing serum potassium may have been responsible for the captopril potentiated GIH. Similar GIH was found in four non-insulin dependent diabetic control patients with mineralocorticoid insufficiency (Group 1) but without captopril treatment, which could be prevented by desoxycorticosterone. Normal serum potassium responses to glucose, uninfluenced by desoxycorticosterone were shown in four untreated hypertensive control patients (Group 2).

Adolescent↗
PubMed1982

Comparison of azosemide and furosemide in ascitic patients without and during administration of spironolactone.

Clinical, pharmacodynamic, and renal effects of a new diuretic, azosemide, were studied and compared with those of furosemide. Graded single intravenous (100-1600 mg) or peroral (100-400 mg) doses were administered to six patients with ascites due to liver cirrhosis without and during basic treatment with spironolactone. A standard peroral dose (160 mg) of both diuretics was found to have similar effectiveness. There was no difference in the time-course of action as determined on the basis of 24-h urine volume, sodium excretion, and osmolal clearance in four patients during basic treatment with spironolactone. However, azosemide appeared to be more effective than furosemide in those patients in whom a dose-response curve was established. Unlike furosemide, azosemide was much more effective when given intravenously than orally. Our study confirmed that azosemide is a "loop diuretic" with renal sites of action similar to those of furosemide. However, it has a higher efficiency, probably due to the steeper dose-response relationship.

Administration, Oral↗
PubMed1981

Influence of posture on serum potassium changes during standard glucose tolerance test.

Serum potassium (SK) decreased in a significantly greater extent (p less than 0.005) in the recumbent (0.91 +/- 0.11 mmol/L) than in the upright position (0.57 +/- 0.07 mmol/L) in the course of the standard glucose tolerance test (StGTT) in 12 normal people. The clinical implications with special respect to "paradoxical hyperkalemia" are discussed.

Glucose Tolerance Test↗