title: Effects of potassium supplementation on the recovery of thyrotoxic periodic paralysis.
abstract: Potassium supplements have been recommended to hasten recovery and prevent cardiopulmonary complications in patients with thyrotoxic periodic paralysis (TPP). However, this recommendation has not yet been proven efficacious. Thirty-two patients with acute attacks of TPP over a 3-year-period were divided into 2 groups. Group A (n = 12) was a control group treated with normal saline infusion 125 mL/hr only. Group B (n = 20) received intravenous KCl administration at a rate of 10 mmol/hr in normal saline 125 mL/hr. During the attack and for 6 hours after muscle recovery, hemodynamics were continuously recorded and muscle strength and plasma K(+) concentration were measured hourly. The sex, age, muscle strength, thyroid function, biochemical values including plasma K(+) levels, as well as the time from attack to therapy (3.6 +/- 1.6 v 3.3 +/- 1.0 hr) were not significant between the 2 groups. However, recovery time was significantly shorter in the KCl group than the control (6.3 +/- 3.8 v 13.5 +/- 7.5 hr, P < .01). Rebound hyperkalemia greater than 5.5 mmol/L occurred in 40% patients receiving KCl. The dose of KCl administered and peak K(+) concentration were positively correlated (r = 0.85, P < .001). In conclusion, KCl therapy proves to help the recovery of paralysis in TPP associated with rebound hyperkalemia. KCl supplementation should be given as small as possible (<10 mmol/hr) to avoid rebound hyperkalemia unless there are cardiopulmonary complications.
authors.affiliation: Division of Nephrology, Department of Medicine, Cardinal Tien Hospital, Fu-Jen Catholic University School of Medicine, Taipei, Taiwan.
authors.forename: Kuo-Cheng
authors.initials: KC
authors.lastname: Lu
authors.forename: Yu-Juei
authors.initials: YJ
authors.lastname: Hsu
authors.forename: Jainn-Shiun
authors.initials: JS
authors.lastname: Chiu
authors.forename: Yaw-Don
authors.initials: YD
authors.lastname: Hsu
authors.forename: Shih-Hua
authors.initials: SH
authors.lastname: Lin
mesh_terms: D000328:Adult; D000367:Age Factors; D001794:Blood Pressure / Q000187:drug effects; D004562:Electrocardiography / Q000187:drug effects; D005500:Follow-Up Studies; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D006947:Hyperkalemia / Q000209:etiology; D007008:Hypokalemia / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D009119:Muscle Contraction / Q000187:drug effects; D018482:Muscle, Skeletal / Q000187:drug effects; D010243:Paralysis / Q000188:drug therapy*; D011188:Potassium / Q000097:blood; D011189:Potassium Chloride / Q000627:therapeutic use*; D020127:Recovery of Function; D012737:Sex Factors; D012965:Sodium Chloride; D013958:Thyroid Crisis / Q000188:drug therapy* / Q000503:physiopathology; D013961:Thyroid Gland / Q000503:physiopathology; D013997:Time Factors
chemical_list: D012965:Sodium Chloride; D011189:Potassium Chloride; D011188:Potassium