Response of Hyperkalemia to Medical Treatment in End Stage Renal Disease

Abstract

End stage renal disease patients commonly encounter metabolic complications of their renal disease or dialysis related complications. The most common cause of sudden death in patients with ESRD is hyperkalemia, which is often encountered in patients after missed dialysis or dietary indiscretion. Metabolic acidosis in renal failure causes an increase in serum potassium. The rise in serum potassium is a very important cause of ventricular arrhythmias and cardiac death. Medical therapy for hyperkalemia can be lifesaving while patient is waiting for dialysis which is not readily available because of meagre resources of the hospitals. Objective: Our objective was to determine the mean decrease in serum potassium 1 hour after medical treatment (inj.10% Calcium Gluconate, nebulization with Salbutamol and 25% Dextrose water 100 ml plus 12 units regular insulin) in patients of hyperkalemia due to ESRD. Study Design: This study was a cross sectional study. Settings: Medicine Inpatient Department, Allied Hospital, Faisalabad. Period: Duration of study was six months from 06-08-2015 to 05-02-2016. Methods: Fifty patients including males and females with age ranges from 14-70 years having end stage renal disease with serum Potassium more than 5.5 mEq/L at presentation were taken according to inclusion criteria. Results: 50 patients were enrolled in study. Mean age of study population was 47.68 ± 12.14.  29 (58%) were male and 21 (42%) were female. Serum potassium at start of study was 6.024 ± 0.30 and 1 hour after medical therapy it was 5.15 ± 0.35. Mean decrease in serum potassium was 0.874 ± 0.24. Paired sample t test was applied (P-value 0.0001). Conclusions: It has been concluded from this study that medical therapy in hyperkalemia decreases serum potassium significantly and is an effective way to bridge interval to dialysis in patients with significant hyperkalemia.