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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Bolus administration of intravenous glucose in the treatment of hyperkalemia: A randomized controlled trial
Nephron - Physiology, Volume 126, No. 1, Year 2014
Notification
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Description
Background: Hyperkalemia is a common medical emergency that may result in serious cardiac arrhythmias. Standard therapy with insulin plus glucose reliably lowers the serum potassium concentration ([K
+
]) but carries the risk of hypoglycemia. This study examined whether an intravenous glucose-only bolus lowers serum [K
+
] in stable, nondiabetic, hyperkalemic patients and compared this intervention with insulin-plus-glucose therapy. Methods: A randomized, crossover study was conducted in 10 chronic hemodialysis patients who were prone to hyperkalemia. Administration of 10 units of insulin with 100 ml of 50% glucose (50 g) was compared with the administration of 100 ml of 50% glucose only. Serum [K
+
] was measured up to 60 min. Patients were monitored for hypoglycemia and EKG changes. Results: Baseline serum [K
+
] was 6.01 ± 0.87 and 6.23 ± 1.20 mmol/l in the insulin and glucose-only groups, respectively (p = 0.45). At 60 min, the glucose-only group had a fall in [K
+
] of 0.50 ± 0.31 mmol/l (p < 0.001). In the insulin group, there was a fall of 0.83 ± 0.53 mmol/l at 60 min (p < 0.001) and a lower serum [K
+
] at that time compared to the glucose-only group (5.18 ± 0.76 vs. 5.73 ± 1.12 mmol/l, respectively; p = 0.01). In the glucose-only group, the glucose area under the curve (AUC) was greater and the insulin AUC was smaller. Two patients in the insulin group developed hypoglycemia. Conclusion: Infusion of a glucose-only bolus caused a clinically significant decrease in serum [K
+
] without any episodes of hypoglycemia. © 2014 S. Karger AG, Basel.
Authors & Co-Authors
Chothia, Mogamat Yazied
South Africa, Stellenbosch
Stellenbosch University
Halperin, Mitchell Lewis
Canada, Toronto
University of Toronto
Canada, Toronto
Li ka Shing Knowledge Institute
Rensburg, Megan Amelia
South Africa, Stellenbosch
Stellenbosch University
Hassan, Mogamat Shafick
South Africa, Bellville
Cape Peninsula University of Technology
Davids, Mogamat Razeen
South Africa, Stellenbosch
Stellenbosch University
Statistics
Citations: 32
Authors: 5
Affiliations: 4
Identifiers
Doi:
10.1159/000358836
e-ISSN:
16602137
Research Areas
Noncommunicable Diseases
Study Design
Randomised Control Trial
Study Approach
Quantitative