Extent of Fall in Serum Potassium by Medical Therapy in End Stage Renal Disease

Abstract

Aim: To observe the mean alteration in potassium levels one-hour post-antihyperkalemic treatment in end stage renal disease patients presenting with hyperkalemia. Study design: Quazi interventional (experimental) study. Place and duration of study: Department of Medicine, Sir Ganga Ram Hospital Lahore from 28th June 2018 to 27th December 2018. Methodology: Sixty patients of both genders with age range between 14 to 70 years having stage 5 CKD (thrice-weekly dialysis dependent) for at least 6 months with raised serum potassium (>5.5 mEq/L). These patients were given medical treatment in the form of salbutamol nebulization, injectable calcium gluconate, and 100ml 25% dextrose water solution neutralized with Humulin R Insulin 12 units. Serum potassium was reassessed 1 hour after the treatment. Mean change in serum potassium was observed and was compared across various subgroups of patients. A written informed consent was taken from each patient. Results: In the current study, mean age of our studied population was 50.6±10.4 years with male-gender dominance (81.7%). Mean ESRD duration was 11.8±3.7 months while the mean BMI was 27.6±3.6Kg/m2. 15 (25.0%) patients were obese. The serum potassium level at presentation ranged from 5.6mEq/L to 6.9mEq/L with a mean of 6.25±0.39mEq/L. The serum potassium level 1 hour after medical treatment ranged from 4.8mEq/L to 6.3mEq/L with a mean of 5.58±0.43mEq/L. This change in mean serum potassium was significant (p-value<0.001) on paired sample t-test. The change in serum potassium level ranged from 0.5-0.9mEq/L with a mean of 0.676±0.123mEq/L. Similar mean change in serum potassium level was observed when stratified for age, gender, BMI and duration of ESRD. Keywords: End Stage Renal Disease, Hemodialysis, Hyperkalemia, Medical Treatment