{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T10:21:58Z","timestamp":1790504518562,"version":"4.1.0"},"reference-count":8,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,5,12]],"date-time":"2025-05-12T00:00:00Z","timestamp":1747008000000},"content-version":"vor","delay-in-days":131,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Case Reports in Nephrology"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:p>\n                    <jats:bold>Background:<\/jats:bold>\n                    BRASH syndrome is a life\u2010threatening condition that involves bradycardia, renal failure, atrioventricular blockade, shock, and hyperkalemia. It is often resistant to conventional treatments and requires prompt diagnosis and management. We report a case of BRASH syndrome successfully treated in the Emergency Department and Nephrology Department.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Case Presentation:<\/jats:bold>\n                    A 57\u2010year\u2010old man with hypertension, diabetes, ischemic heart disease, and chronic kidney disease presented with severe diarrhea, lethargy, and shock. He had hyperkalemia, metabolic acidosis, and acute kidney injury. His electrocardiogram showed sinus bradycardia with complete AV block. He was on bisoprolol, which was discontinued. He received hemodialysis, potassium\u2010lowering agents, and vasoactive drugs. His renal function improved, and his heart rate normalized with first\u2010degree AV block. He was discharged with advice to avoid AV\u2010blocking agents and follow\u2010up with nephrology and cardiology.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Conclusions:<\/jats:bold>\n                    BRASH syndrome is a serious complication of hyperkalemia, hypotension, and bradycardia in patients with kidney dysfunction and AV\u2010blocking medications. It may require hemodynamic support and temporary pacemaker insertion. Early recognition and treatment of this entity can reduce mortality and morbidity.\n                  <\/jats:p>","DOI":"10.1155\/crin\/3405566","type":"journal-article","created":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T02:20:16Z","timestamp":1747102816000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["BRASH Syndrome: A Patient With Chronic Kidney Disease and AV Nodal Blockers"],"prefix":"10.1155","volume":"2025","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7505-1521","authenticated-orcid":false,"given":"Zein A","family":"Alsayed-Ahmad","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-6942-035X","authenticated-orcid":false,"given":"Sanaa","family":"Saddour","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-2976-1575","authenticated-orcid":false,"given":"Tasnim Mustafa","family":"Saddour","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2219-0912","authenticated-orcid":false,"given":"Mohamad Moafak","family":"Hariri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-8203-8893","authenticated-orcid":false,"given":"Karam","family":"Albitar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-5957-0458","authenticated-orcid":false,"given":"Sami","family":"Albitar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,5,12]]},"reference":[{"key":"e_1_2_12_1_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpcardiol.2023.101663"},{"key":"e_1_2_12_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jemermed.2020.05.001"},{"key":"e_1_2_12_3_2","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.35620"},{"key":"e_1_2_12_4_2","doi-asserted-by":"publisher","DOI":"10.1136\/bcr-2019-233825"},{"key":"e_1_2_12_5_2","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.6985"},{"key":"e_1_2_12_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00484-013-0755-7"},{"key":"e_1_2_12_7_2","doi-asserted-by":"publisher","DOI":"10.12659\/AJCR.934600"},{"key":"e_1_2_12_8_2","doi-asserted-by":"publisher","DOI":"10.21542\/gcsp.2023.2"}],"container-title":["Case Reports in Nephrology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/crin\/3405566","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1155\/crin\/3405566","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/crin\/3405566","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T17:41:16Z","timestamp":1773769276000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1155\/crin\/3405566"}},"subtitle":[],"editor":[{"given":"David","family":"Mudge","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2025,1]]},"references-count":8,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2025,1]]}},"alternative-id":["10.1155\/crin\/3405566"],"URL":"https:\/\/doi.org\/10.1155\/crin\/3405566","archive":["Portico"],"relation":{},"ISSN":["2090-6641","2090-665X"],"issn-type":[{"value":"2090-6641","type":"print"},{"value":"2090-665X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1]]},"assertion":[{"value":"2024-03-08","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-01-30","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-05-12","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"3405566"}}