Kidney international
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Kidney international · Jan 1993
Clinical Trial Controlled Clinical TrialEffect of insulin-plus-glucose infusion with or without epinephrine on fasting hyperkalemia.
Extrarenal potassium disposal is an important defense against hyperkalemia in patients with end-stage renal disease. Both insulin and epinephrine are important modulators of this process. Hemodialysis patients are prone to developing hyperkalemia during fasting. ⋯ The plasma potassium increased by 0.58 +/- 0.13 mmol/liter (P = 0.002) after 18 hours of fasting. Administration of insulin with dextrose at a dose that doubled the plasma insulin levels within the physiologic range (9.3 +/- 1.1 vs. 20.2 +/- 2.3 mU/liter, P < 0.002), completely prevented the rise in plasma potassium (+0.06 +/- 0.13 mmol/liter, P = 0.64). Epinephrine did not significantly change the plasma potassium during fasting alone (+0.05 +/- 0.09 mmol/liter, P = 0.59), whereas it lowered the potassium significantly (-0.16 +/- 0.04 mmol/liter, P = 0.003) when the subjects were receiving insulin with glucose.(ABSTRACT TRUNCATED AT 250 WORDS)