• Clin Med (Lond) · Jul 2024

    Reducing the harm associated in treating hyperkalaemia with insulin and dextrose.

    • Abou SherifSaraSRenal and Transplant Centre, Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom; Chelsea and Westminster Hospital, Chelsea and Westminster Hospital NHS Foundation Trust, London, United Kingdom. Electronic a, Irene Katsaiti, Hannah Jebb, Serena Banh, Rachna Bedi, Jeremy Levy, David Thomas, Damien Ashby, and Richard Corbett.
    • Renal and Transplant Centre, Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom; Chelsea and Westminster Hospital, Chelsea and Westminster Hospital NHS Foundation Trust, London, United Kingdom. Electronic address: s.abousherif@nhs.net.
    • Clin Med (Lond). 2024 Jul 1; 24 (4): 100222100222.

    AbstractInpatient treatment of hyperkalaemia with insulin and dextrose can be complicated by iatrogenic hypoglycaemia. We sought to assess the incidence of hypoglycaemia in hospitalised patients with renal disease and assess the impact of the introduction of a local guideline incorporating the use of sodium zirconium cyclosilicate (SZC) for patients with moderate hyperkalaemia. After establishing a significant burden of hypoglycaemia in the initial observation period, a requirement for hourly capillary blood glucose monitoring (for up to 6 h) following the administration of insulin for hyperkalaemia was incorporated into the guidelines. The two-fold introduction of SZC alongside changes in patient care after the administration of insulin/dextrose resulted in more appropriate use of insulin/dextrose, as well as a significant (73%) reduction in the iatrogenic burden of hypoglycaemia (P = 0.04).Copyright © 2024. Published by Elsevier Ltd.

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