[Fwd: Re: [HSF] Re: Persistent hypokalemia]

[prasannasimha]

The problem with the Cockroft Gault equation is that every patient of 
mine would theoretically have an "abnormal GFR" assuming a low normal of 
97 for males and  88 for females.
Prasanna
psimha wrote:
> I have a "calculated GFR" and not an absolute measurement. I fully 
> agree with your statement and thus I said that this patient may have 
> been "pushed over the brink" with addition of Heparin.
> The patients renal function is normal now.
> Prasanna
> Ben Bidstrup wrote:
>> Prasanna,
>> Can you calculate the GFR? A slightly raised se Cr in a small person 
>> may mean quite significant impairment.
>>> Alsadd,
>>> This case was with Hyperkalemia.
>>> I  think that this was a case of Aldosterone inhibition due to 
>>> Heparin in a case with borderline renal dysfunction. May be it 
>>> doesn't matter in a "normal" kidney but could become significant in 
>>> a borderline kidney. The creatinine had marginally raised but that 
>>> would mean a damage of slightly over 50 % of the nephrons.
>>> Any way this small statement in a corner of a web site helped me 
>>> make a decision that we must all actually should be pretty well 
>>> aware off. I never remember reading this in any pharmacology book.
>>>
>>> Prasanna
>>>
>>> A wrote:
>>>> Prasanna:
>>>>
>>>>
>>>> I am glad it turned out well for the patient. About two years ago I 
>>>> posted a
>>>> problem with persistent hypokalemia in spite of good hemodialysis. 
>>>> We could
>>>> not determine the cause and this happened in a number of patients 
>>>> over the
>>>> course of few years in  a few and far in between cases.
>>>>
>>>> Now perhaps we can add Heparin as a possible cause. Any additional 
>>>> thought
>>>> on this We have not had a similar problem for over a year now. I 
>>>> hope it
>>>> stays that way.
>>>>
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>
>