Serum potassium handling at pre- and posthemodialysis in patients with end-stage renal disease.
The current study simultaneously measured serum and red blood cell (RBC) K+ as well as plasma pH, bicarbonate, serum insulin, and aldosterone at pre-, end-, and at 5, 11, and 19 hours posthemodialysis in 25 patients with end-stage renal disease and evaluated the factors influencing serum K+ levels during those periods. Our patients were studied under their current dietary conditions. At end-dialysis, serum K+ levels decreased, but RBC K+ levels were not changed. At this time point, the decrease in serum K+ levels was exclusively caused by removal of K+ by dialysis. At 5 hours postdialysis, serum K+ rapidly increased, whereas RBC K+ decreased. The 5 hour postdialysis serum K+ increase negatively correlated with the decrease in serum insulin levels. At 11 hours postdialysis, serum K+ slowly but significantly increased, and RBC K+ increased to those levels at pre- and end-dialysis. At 19 hours postdialysis, serum K+ further increased, but RBC K+ remained stable. From 5 to 19 hours postdialysis, the increase in serum K+ was independent of changes in plasma pH, bicarbonate, insulin, and aldosterone but was associated with both the predialysis serum K+ levels and the magnitude of the decrease in serum K+ at end-dialysis.
Muto
Shigeaki
S
Department of Nephrology, Jichi Medical School, Minamikawachi, Tochigi, Japan.
Sebata
Kiyoko
K
Ohashi
Michie
M
Yamada
Takako
T
Matsumoto
Hisako
H
Mukouyama
Tomoko
T
Namiki
Sachiko
S
Kusano
Eiji
E
Asano
Yasushi
Y
D000328:Adult; D000368:Aged; D000450:Aldosterone / Q000097:blood; D001806:Blood Urea Nitrogen; D002245:Carbon Dioxide / Q000097:blood; D004912:Erythrocytes / Q000378:metabolism; D005260:Female; D006801:Humans; D007328:Insulin / Q000097:blood; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000097:blood; D011188:Potassium / Q000097:blood*; D006435:Renal Dialysis
D007328:Insulin; D002245:Carbon Dioxide; D000450:Aldosterone; D011188:Potassium; D010100:Oxygen