SHOULD GLUCOSE BE ADMINISTERED BEFORE, WITH, OR AFTER INSULIN, IN THE MANAGEMENT OF HYPERKALEMIA

被引：19

作者：

LJUTIC, D

RUMBOLDT, Z

机构：

[1] Department of Internal Medicine, Clinical Hospital, Split

来源：

RENAL FAILURE | 1993年 / 15卷 / 01期

关键词：

GLUCOSE; HYPOKALEMIC EFFECT; HYPOGLYCEMIA; INSULIN;

D O I：

10.3109/08860229309065576

中图分类号：

R5 [内科学]; R69 [泌尿科学（泌尿生殖系疾病）];

学科分类号：

1002 ; 100201 ;

摘要：

To assess the hypokalemic effect of intravenous glucose (25 g i.v. in 5 min) followed by regular insulin (10 U) bolus, as well as the incidence of hypoglycemia, a well-known side effect of this intervention, nine uremic patients on maintenance hemodialysis were studied Measurements were done of plasma potassium, glucose, insulin, and C-peptide before, and 15, 30, 45, and 60 min after glucose and insulin. The intervention induced a significant fall in plasma potassium level, a significant rise and then fall in plasma glucose, and a significant increase in the insulin and C-peptide levels. These data suggest that hypertonic glucose infusion should precede, not follow, the insulin bolus in the management of hyperkalemia. Such an approach is clinically effective and well tolerated, with no hypoglycemic side effects.

引用

页码：73 / 76

页数：4

共 14 条

[1]

Brezis M., Rosen S., Epstein F.H., Acute renal failure, The Kidney, pp. 735-799, (1986)

[2]

Levinsky N.G., Fluids and electrolytes, Harrison's principles of internal medicine, pp. 275-289, (1991)

[3]

Iqbal Z., Friedman E.A., Preferred therapy of hyperkalemia in renal insufficiency: Survey of nephrology training-program directors, N Engl J Med, 320, pp. 60-61, (1989)

[4]

Blumberg A., Weidmann P., Shaw S., Guadinger M., Effect of various therapeutic approaches on plasma potassium and major regulating factors in terminal renal failure, Am J Med, 85, pp. 507-512, (1988)

[5]

Lens X.M., Montoliou J., Cases A., Campistol J.M., Revert L., Treatment of hyperkalaemia in renal failure: Salbutamol v. insulin, Nephrol Dial Transpl, 4, pp. 228-232, (1989)

[6]

Allon M., Copkney C., Albuterol and insulin for treatment of hyperkalaemia in hemodialysis patients, Kidney Int, 38, pp. 869-872, (1990)

[7]

Goldfarb S., Cox M., Singer I., Goldberg M., Acute hyperkalemia induced by hyperglycemia: Hormonal mechanism, Ann Int Med, 84, pp. 426-432, (1976)

[8]

Viberti G.C., Glucose-induced hyperkalemia: A hazard for diabetics?, Lancet, 1, pp. 690-691, (1978)

[9]

Zierler K.L., Hyperpolarization of muscle of insulin in a glucose-free environment, Am J Physiol, 197, pp. 524-526, (1951)

[10]

LaManna V.R., Ferrier G.R., Electrophysiological effects of insulin on normal and depressed cardiac tissues, Am J Physiol, 240, pp. H636-H644, (1981)

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