[Hyperkalemia]. / ABC om Hyperkalemi.

Hyperkalemia is a relatively common electrolyte abnormality that in serious cases can lead to life-threatening arrhythmias. There are a number of factors that can contribute to hyperkalemia, and in most cases some level of kidney failure is present. The management of hyperkalemia depends on the underlying cause and the level of potassium. This paper briefly examines the pathophysiological mechanisms behind hyperkalemia, with a special focus on treatment.

N-Terminal Prosomatostatin as a Risk Marker for Cardiovascular Disease and Diabetes in a General Population.

CONTEXT: Somatostatin inhibits a range of hormones, including GH, insulin, and glucagon, but little is known about its role in the development of cardiometabolic disease. OBJECTIVE: The objective of the study was to investigate whether fasting plasma concentration of N-terminal prosomatostatin (NT-proSST) is associated with the development of diabetes, coronary artery disease (CAD), and mortality. DESIGN, SETTING, AND PARTICIPANTS: NT-proSST was measured in plasma from 5389 fasting participants of the population-based study Malmö Preventive Project, with a mean baseline age of 69.4 ± 6.2 years. Cox proportional hazards models adjusted for traditional cardiovascular risk factors were used to investigate the relationships between baseline NT-proSST and end points, with a mean follow-up of 5.6 ± 1.4 years. MAIN OUTCOME MEASURES: CAD, diabetes, and mortality were measured. RESULTS: Overall, NT-proSST (hazard ratio [HR] per SD increment of log transformed NT-proSST) was unrelated to the risk of incident diabetes (220 events; HR 1.05; 95% confidence interval [CI] 0.91-1.20; P = .531) but was related to the risk of incident CAD (370 events; HR 1.17; 95% CI 1.06-1.30; P = .003), all-cause mortality (756 events; HR 1.24; 95% CI 1.15-1.33; P < .001), and cardiovascular mortality (283 events; HR 1.33; 95% CI 1.19-1.43; P < .001). The relationships were not linear, with most of the excess risk observed in subjects with high values of NT-proSST. Subjects in the top vs bottom decile had a severely increased risk of incident CAD (HR 2.41; 95% CI 1.45-4.01; P < .001), all-cause mortality (HR 1.84; 95% CI 1.33-2.53; P < .001), and cardiovascular mortality (HR 2.44; 95% CI 1.39-4.27; P < .001). CONCLUSION: NT-proSST was significantly and independently associated with the development of CAD, all-cause mortality, and cardiovascular mortality.