Titre du document / Document title

Effect of albuterol treatment on subsequent dialytic potassium removal

Auteur(s) / Author(s)

ALLON M. ; SHANKLIN N. ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

Univ. Alabama Birmingham, nephrology res. training cent., Birmingham AL, ETATS-UNIS

Résumé / Abstract

. End-stage renal disease patients presenting with severe hyperkalemia are frequently treated with albuterol to lower their plasma potassium acutely, until emergent hemodialysis can be initiated. Such treatment stimulates potassium shifts from the extracellular to the intracellular fluid compartments. The resulting reduction of potassium concentration gradient between the blood and dialysate may potentially attenuate the efficacy of potassium removal during the ensuing hemodialysis treatment. To evaluate the effect of prior albuterol treatment on dialytic potassium removal, seven chronic hemodialysis patients were studied prospectively on two separate occasions. In one study the patients received 20 mg nebulized albuterol 30 minutes before dialysis ; in the control study, albuterol treatment was omitted. Plasma potassium decreased 30 minutes after albuterol treatment (-0.84 ± 0.06 mmol/L ; P < 0.001) and remained unchanged in the corresponding period of the control experiment. Plasma potassium decreased during dialysis in both experimental protocols, but was significantly lower throughout dialysis in the albuterol study, as compared with the control study. Cumulative dialytic potassium removal was significantly lower following albuterol pretreatment compared with the control experiment (29.0 ± 5.7 mmol v 49.6 ± 7.0 mmol ; P < 0.001). These observations suggest that acute albuterol therapy in patients with end-stage renal disease may substantially decrease potassium removal in the ensuing hemodialysis session. This may lead to rebound hyperkalemia several hours after the dialysis treatment.

Revue / Journal Title

American journal of kidney diseases   ISSN 0272-6386 

Source / Source

1995, vol. 26, n^o4, pp. 607-613 (21 ref.)

Langue / Language

Anglais

Editeur / Publisher

Elsevier, Orlando, FL, ETATS-UNIS  (1981) (Revue)

Mots-clés anglais / English Keywords

Renal failure ; Chronic ; Hyperkaliemia ; Hemodialysis ; Beta blocking agent ; Insulin ; Combined treatment ; Treatment ; Complication ; Human ; Inorganic element ; Urinary system disease ; Renal disease ; Metabolic disorder ; Hydroelectrolytic balance disorder ; Extrarenal dialysis ; Chemotherapy ;

Mots-clés français / French Keywords

Insuffisance rénale ; Chronique ; Hyperkaliémie ; Hémodialyse ; Bloquant β-adrénergique ; Insuline ; Traitement associé ; Traitement ; Complication ; Homme ; Elément minéral ; Albutérol ; Appareil urinaire pathologie ; Rein pathologie ; Trouble métabolisme ; Trouble équilibre hydroélectrolytique ; Epuration extrarénale ; Chimiothérapie ;

Mots-clés espagnols / Spanish Keywords

Insuficiencia renal ; Crónico ; Hiperpotasemia ; Hemodiálisis ; Bloqueador β-adrenérgico ; Insulina ; Tratamiento asociado ; Tratamiento ; Complicación ; Hombre ; Elemento inorgánico ; Aparato urinario patología ; Riñón patología ; Trastorno metabolismo ; Trastorno equilibrio hidroelectrolítico ; Depuración extrarrenal ; Quimioterapia ;

Localisation / Location

INIST-CNRS, Cote INIST : 19098, 35400005849949.0080