Hypernatremia during correction of hypercalcemia.
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Aged↗
Biomedical subjects
R Kalaitzidis
Publications and source records attributed to R Kalaitzidis.
Effectiveness and metabolic effects of perindopril and diuretics combination in primary hypertension.
The effectiveness as well as the metabolic effects of the combination of diuretics [hydrochlorothiazide (HCT) vs indapamide (IND)] and perindopril (P) in 14 patients (7 male, 7 female) aged 37-62 years with mild idiopathic hypertension were studied. Following a 4-week wash-out period and a 4-week period of monotherapy with P (4 mg/daily), IND (2.5 mg/daily) or HCT (25 mg/daily) was added for 4 weeks. Selection of the diuretic agent was random. Following a 4-week wash-out period from the diuretic, in which only P was given, the alternative diuretic was administered for another period of 4 weeks. P decreased blood pressure levels significantly. However, the drug was more efficacious in patients with higher plasma renin activity (PRA). Combination treatment induced an additional decrease in the blood pressure levels, mainly in patients with lower PRA. The combination of P + HCT was more effective than the combination P + IND. The addition of either HCT or IND evoked a small but statistically significant increase in serum glucose levels while fasting as well as during the 75 g oral glucose challenge. However, insulin levels did not change significantly during the study. Small but not statistically significant changes in serum electrolytes and lipid parameters were observed during the various phases of the study, while a statistically significant increase in the serum uric acid was noticed when the combination P + HCT was given. We conclude: (1) P in small doses is an effective and safe antihypertensive agent, (2) PRA has a predictive value in determining the effectiveness of P treatment, (3) the combination of P with small doses of HCT or IND is more efficacious than P alone, (4) the combination treatment has adverse effects in the carbohydrate tolerance, while there are not significant changes in serum electrolyte and lipid parameters.
Adult↗
Hypomagnesemia in alcoholic patients.
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Alcoholism↗
Multiple electrolyte abnormalities after pamidronate administration.
Pamidronate constitutes a major advance in the treatment of tumor-associated hypercalcemia. However, transient electrolyte abnormalities have been reported after pamidronate administration. We describe here a patient with multiple myeloma and severe hypercalcemia who developed transient but significant electrolyte disturbances (mainly hypophosphatemia and hypomagnesemia) after a single dose of 90 mg of pamidronate, focusing on the underlying pathophysiological mechanisms.
Antineoplastic Agents↗
Ambulatory blood pressure monitoring in hemodialysis patients.
The aim of our study was the detection of blood pressure (BP) variability during a dialysis session and in the interdialytic period in normotensive and hypertensive hemodialysis (HD) patients using ambulatory blood pressure monitoring (ABPM). Twenty-two HD patients aged 54 (range, 33-78) years who were on HD for a mean of 17.7 (range, 1-70) months were studied. Twelve patients were hypertensives, while the remaining 10 were normotensives (BP < 140/90 mm Hg). In all patients ABPM was performed for a total of 48 h including an HD session. A significant decrease in systolic BP, diastolic BP and mean BP was observed at the end of a dialysis session in hypertensive HD patients. However, in only five patients a reduction of more than 5% In mean arterial BP was noticed. No significant differences were observed in the BP values between the first and the second day after the HD in hypertensive HD patients. Interdialytic BP (both systolic and diastolic) was significantly higher than the postdialysis BP measured either in the clinic or with the ABPM in these patients. Normotensive HD patients exhibited a normal diurnal variation of BP during the first day after the HD session (decrease in BP during the night). On the second day after the HD session an increase in BP (mainly of systolic BP), as well as a loss of diurnal variation were observed. On the contrary, hypertensive HD patients did not exhibit the normal diurnal variation of BP during the first or the second day after the HD session. Hypertensive HD patients exhibited increased daytime and night time BP loads. On the other hand, normotensive HD patients presented with BP loads within normal limits, even though a small increase in these loads was observed on the second day after dialysis. In conclusion, while hypertensive HD patients present a loss of the normal diurnal variation of BP, normotensive HD patients exhibit normal variation during the first day after the HD session. The loss of the diurnal variation during the second day in these patients suggests a volume-dependent state.
Adult↗
Unravelling the links between calcium excretion, salt intake, hypertension, kidney stones and bone metabolism.
Evidence from animal, clinical and epidemiological studies suggests that high blood pressure is associated with abnormalities of calcium metabolism, leading to increased calcium loss, secondary activation of the parathyroid gland, increased movement of calcium from bone and increased risk of urinary tract stones. Some of these abnormalities are detectable in children and young people and continue throughout adult life. The cluster of abnormalities may be due either to a primary renal tubular defect ('renal calcium leak' hypothesis) or to the effect of central volume expansion seen in hypertension ('central blood volume' hypothesis). A high salt intake is known to aggravate these abnormalities and their consequences. If substantial calcium loss related to high blood pressure is sustained over many decades, increased excretion of calcium in the urine may result in an increased risk of urinary tract stones, and the increased movement of calcium from bone may result in higher rates of bone mineral loss, thereby increasing the risk of osteoporosis. The present review summarises the evidence, suggests a unifying hypothesis and discusses clinical and public health implications.
Bone and Bones↗