Intractable hyperkalemia due to nicorandil induced potassium channel syndrome

Abstract

Nicorandil is a commonly used antianginal agent, which has both nitrate-like and ATP-sensitive potassium (K ATP ) channel activator properties. Activation of potassium channels by nicorandil causes expulsion of potassium ions into the extracellular space leading to membrane hyperpolarization, closure of voltage-gated calcium channels and finally vasodilatation. However, on the other hand, being an activator of K ATP channel, it can expel K + ions out of the cells and can cause hyperkalemia. Here, we report a case of nicorandil induced hyperkalemia unresponsive to medical treatment in a patient with diabetic nephropathy.

Keywords

• Atrial fibrillation; Cardiac surgery; Diastolic dysfunction; Diastolic function; Postoperative
• Postoperative pain
• presternal bupivacaine infusion
• sternotomy
• Aprotinin; Bleeding; Cardiopulmonary bypass; Paediatric open-heart surgery; Tranexamic acid
• Airway; dexmedetomidine; radiographic assessment
• Cardiac resynchronization therapy; coronary artery bypass; heart failure
• Acute kidney injury
• Cardiac surgery
• Neutrophil gelatinase-associated lipocalin
• Anti-platelet therapy; Bleeding; Coronary artery bypass grafting; Multiplate; Platelet Dysfunction; Platelet function assessment
• Developing country; outcomes; quality improvement
• Cardiac surgery; Davinci; One-lung ventilation; Totally endoscopic coronary artery bypass; Transesophageal echocardiography; Robotic surgery; Minimally invasive cardiac surgery
• Atrial septal defects
• Congenital heart disease
• Echocardiography
• Transthoracic echocardiography
• Transesophageal echocardiography
• Three- dimensional echocardiography
• Two-dimensional echocardiography
• Clinical research
• measurement types
• predictive modelling
• statistical analysis
• Aortic dissection flap
• intra-operative echocardiography
• three-dimensional transesophageal echocardiography
• type A aortic dissection
• Left ventricular rupture
• mitral valve replacement
• risk factors
• Coronary artery bypass graft; hypoxemia; patent foramen ovale; stroke
• Left ventricle; Myxoma; Thrombus
• Anesthesia; Aortic stenosis; Aortic valve replacement; Cesarean section; Pregnancy
• ATP-sensitive potassium channels; channelopathy; hyperkalemia; nicorandil