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Renal Disease; Fluid and Electrolyte Disorders
Published in John S. Axford, Chris A. O'Callaghan, Medicine for Finals and Beyond, 2023
Ultimately, the potassium must be removed from the body. If the patient's kidneys are functioning, this can be achieved by the administration of fluids and diuretics such as frusemide. If renal function is impaired, dialysis or haemofiltration can be used to remove the potassium. Oral or rectal administration of cation exchange resins is of minimal benefit and causes constipation, but it may bind potassium in the gut (EMERGENCY PRESENTATION 8.1).
Etiology of Geophagia
Published in Anil Gupta, Geophagia, 2019
Geophagia materials have a high affinity to cation exchange. They can strongly bind to pathogens, endotoxins, and phytotoxins. In this way, geophagy materials can reduce the bioavailability of toxins in the body and offer protection to humans (Johns 1986; Johns and Duquette 1991; Hooda et al. 2002).
General Introduction
Published in David N. Brindley, John R. Sabine, Phosphatidate Phosphohydrolase, 2017
One of the features that has been used to characterize different phosphatidate phosphohydrolases is whether or not they are stimulated by Mg2+. Generally, the cytosolic phosphatidate phosphohydrolase activities show a high dependency49,50,57,58 for Mg2+ whereas those in particulate fractions are stimulated to a much smaller extent.57,58 The whole question of the requirement of different phosphatidate phosphohydrolases is complicated because of the ability of the phosphatidate to bind divalent cations very tightly. Wherever possible the phosphatidate should be treated with Chelex resin to convert it to the K+ salt form.48 This substrate can then be used to determine whether indeed the phosphohydrolase is stimulated by divalent inorganic cations. However, it should also be remembered that subcellular fractions themselves contain divalent cations; for example Ca2+ is concentrated in the endoplasmic reticulum. Furthermore, the homogenizing medium can also be contaminated as in the case of sucrose which may contain Ca2+. It is therefore advisable to treat all suspending media and other reagents where possible with cation exchange resins.
Advances in phosphoproteomics and its application to COPD
Published in Expert Review of Proteomics, 2022
Xiaoyin Zeng, Yanting Lan, Jing Xiao, Longbo Hu, Long Tan, Mengdi Liang, Xufei Wang, Shaohua Lu, Tao Peng, Fei Long
In strong cation exchange (SCX) chromatography, the stationary phase particles of SCX are negatively charged functional groups, and acidic conditions promote interaction between the positively charged tryptic peptides and the SCX particles. Beausoleil et al. [60] found that at pH = 2.7, the carboxyl group would be protonated. The phosphopeptide will retain the negative charge on the phosphate group, causing the tryptic peptide to change from a + 2 charge to a + 1 charge. Hence, the phosphopeptide interacts less with the stationary phase. It is therefore eluted from the column earlier, separating the phosphorylated peptide from the nonphosphorylated peptide (Figure 2a). However, the protein digestion process is prone to missing cleavage sites, affecting the charge number of peptides after digestion and resulting in some phosphopeptides not being eluted first but simultaneously being eluted down with nonphosphorylated peptides. Therefore, to increase the separation effect of SCX, some researchers are now using the SCX method in combination with IMAC, MOAC, and other chemical derivatization methods to improve the separation and identification of phosphopeptides. For example, Gruhler’s group [61] and Trinidad’s group [62] reported that the number of phosphopeptides identified was greatly improved by the total proteins being enzymatically cleaved into peptides by SCX during the first fractionating followed by further enrichment of phosphopeptides using IMAC.
Inpatient management and post-discharge outcomes of hyperkalemia
Published in Hospital Practice, 2021
Jill Davis, Rubeen Israni, Fan Mu, Erin E. Cook, Harold Szerlip, Gabriel Uwaifo, Vivian Fonseca, Keith A. Betts
The clinical management of hyperkalemia varies based on factors such as severity, etiology, and presentation (i.e., acute vs. chronic) [10]. Treatments include a combination of dietary modifications and/or pharmacological agents [10–13]. In acute settings, treatment with calcium gluconate aids in stabilizing the cardiac membrane, use of albuterol, other inhaled beta agonists, or insulin with glucose facilitates redistribution of potassium into cells, and treatment with sodium bicarbonate helps increase potassium excretion via the kidneys [10,13]. However, these acute treatments are followed by additional agents to help eliminate excess potassium, which is important in normalizing serum potassium levels, include diuretics, cation-exchange resins (e.g., sodium-polystyrene sulfonate [SPS]), potassium binders (e.g., sodium zirconium cyclosilicate and patiromer), and hemodialysis [10]. Regardless of the treatment received, ongoing monitoring with repeated assessments of serum potassium levels and electrocardiograms (ECGs) are recommended to mitigate potentially fatal consequences, particularly among patients with severe hyperkalemia [12].
Hb A2-Calderdale [δ2(NA2)His→Asn; HBD: c.7C>A] and Misdiagnosis of Type 2 Diabetes Mellitus Due to Interference with Hb A1c When Using Cation Exchange High Performance Liquid Chromatography: A Case Report
Published in Hemoglobin, 2021
Ida Stangerup, Jesper Petersen, Andreas Glenthøj
In 2018, a general practitioner diagnosed a 39-year-old woman with type 2 diabetes mellitus (T2DM), as a result of several Hb A1c (IFCC standardized) measurements >48.0 mmol/mol (6.5%). Metformin treatment was started, but 2 years of treatment had no effect on Hb A1c levels, which ranged between 50.0–54.0 mmol/mol (6.7–7.1%). The local clinical laboratory uses cation exchange HPLC. After an upgrade from a Tosoh G8 (HLC-723G8, variant mode, Tosoh Bioscience, Tokyo, Japan) to a Tosoh G11 (HLC-723G11, variant mode, Tosoh Bioscience), the Hb A1c result suddenly changed to ‘A hemoglobin variant is suspected. A diagnostic blood glucose is recommended.’ Five years earlier, the patient, in relation to pregnancy and due to her Pakistani ancestry, had already been screened for thalassemia and the most common Hb variants as part of a national pregnancy care program, with no clinically relevant findings. Furthermore, the patient had no history of anemia or reduced mean corpuscular volume (MCV).