Nebulized albuterol for acute hyperkalemia in patients on hemodialysis.
OBJECTIVE
To determine the efficacy and safety of nebulized albuterol in the acute treatment of hyperkalemia in patients on chronic hemodialysis.


METHODS
Prospective, double-blind, and placebo-controlled study.


METHODS
Outpatient hemodialysis clinic at a university medical center.


METHODS
Ten patients on maintenance hemodialysis who had chronic hyperkalemia.


METHODS
Patients received nebulized albuterol therapy (10 mg or 20 mg) or placebo (saline) on three separate occasions, serial measurements of plasma potassium levels, blood pressure, and pulse were then taken for a 2-hour period.


RESULTS
Patients had a significant decrease in plasma potassium concentrations that was evident by 30 minutes and sustained for at least 2 hours after albuterol treatment. After the administration of 10- and 20-mg doses of albuterol, the maximal decrease in the plasma potassium levels was 0.62 +/- 0.09 and 0.98 +/- 0.14 mmol/L (SE), respectively. Nebulized saline administration did not produce a significant change in the plasma potassium concentrations. Patients did not develop symptoms or significant changes in blood pressure or heart rate with albuterol treatment.


CONCLUSIONS
In the doses used, nebulized albuterol therapy resulted in a prompt and significant decrease in the plasma potassium concentrations in patients on hemodialysis, and caused no adverse cardiovascular effects. This treatment should be considered as an important adjunct for acute treatment of serious hyperkalemia in this population of patients.
Allon
M
M
University of Oklahoma School of Medicine, Oklahoma City.
Dunlay
R
R
Copkney
C
C
D000208:Acute Disease; D000328:Adult; D000336:Aerosols; D000368:Aged; D000420:Albuterol / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects; D004311:Double-Blind Method; D004341:Drug Evaluation; D004351:Drug Resistance; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D006947:Hyperkalemia / Q000188:drug therapy*; D008875:Middle Aged; D011446:Prospective Studies; D006435:Renal Dialysis
D000336:Aerosols; D000420:Albuterol