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Bolus administration of intravenous glucose in the treatment of hyperkalemia : a randomized controlled trial

dc.contributor.authorChothia, Mogamat-Yazied
dc.contributor.authorHalperin, Mitchell L.
dc.contributor.authorRensburg, Megan A.
dc.contributor.authorHassan, Mogamat Shafick
dc.contributor.authorDavids, Mogamat Razeen
dc.date.accessioned2014-08-11T14:39:38Z
dc.date.available2014-08-11T14:39:38Z
dc.date.issued2014-02
dc.identifier.citationChothia, M-Y. et al. 2014. Bolus Administration of Intravenous Glucose in the Treatment of Hyperkalemia: A Randomized Controlled Trial. Nephron Physiology, 1(26):1-8, doi:10.1159/000358836.en_ZA
dc.identifier.issn1660-2137 (online)
dc.identifier.issn1660-8151 (print)
dc.identifier.otherdoi:10.1159/000358836
dc.identifier.urihttp://hdl.handle.net/10019.1/95536
dc.descriptionPlease cite as follows:en_ZA
dc.descriptionChothia, M-Y. et al. 2014. Bolus Administration of Intravenous Glucose in the Treatment of Hyperkalemia: A Randomized Controlled Trial. Nephron Physiology, 1(26):1-8, doi:10.1159/000358836.en_ZA
dc.descriptionThe original publication is available at http://www.karger.com/Journal/Issue/261595en_ZA
dc.description.abstractBackground: 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.en_ZA
dc.format.extent8 p.
dc.language.isoen_ZAen_ZA
dc.publisherKargeren_ZA
dc.subjectHyperkalemia -- Treatmenten_ZA
dc.subjectArrhythmia -- Treatmenten_ZA
dc.titleBolus administration of intravenous glucose in the treatment of hyperkalemia : a randomized controlled trialen_ZA
dc.typeArticleen_ZA
dc.description.versionPost-printen_ZA
dc.rights.holderKargeren_ZA


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