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      Marked Bradycardia Associated with Profound Hyperkalemia in Patients with End-Stage Renal Disease

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          Acute toxic effects of sustained-release verapamil in chronic renal failure.

          Four hypertensive patients with chronic renal insufficiency or end-stage renal disease who were treated with sustained-release verapamil hydrochloride subsequently developed acute toxic effects. All four patients developed varying degrees of atrioventricular heart block, hypotension, hyperkalemia, metabolic acidosis, and hepatic dysfunction. Supportive treatment consisted of intravenous catecholamines, sodium polystyrene sulfonate, and dialysis, and all patients recovered completely without any residual hepatic or cardiac disease. Patients with renal impairment who are treated with sustained-release verapamil may accumulate verapamil or its metabolites and develop toxic side effects. We conclude that sustained-release verapamil should be used with caution in this patient population and that patients should be closely monitored for adverse cardiovascular, metabolic, and hepatic side effects.

            Author and article information

            S. Karger AG
            November 1998
            02 November 1998
            : 80
            : 3
            : 355-356
            a Gotenba Daiichi Clinic, b First Department of Medicine and c Third Department of Medicine, Hamamatsu University School of Medicine, d Maruyama Hospital, Hamamatsu, Japan
            45200 Nephron 1998;80:355–356
            © 1998 S. Karger AG, Basel

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            Page count
            Tables: 2, References: 10, Pages: 2
            Self URI (application/pdf): https://www.karger.com/Article/Pdf/45200
            Letter to the Editor

            Cardiovascular Medicine, Nephrology


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