Effect of fludrocortisone acetate on reducing serum potassium levels in patients with end-stage renal disease undergoing haemodialysis.
BACKGROUND
Hyperkalaemia is a commonly encountered problem in dialysis patients with end-stage renal disease (ESRD). The aim of the present study was to assess the effect of fludrocortisone acetate (FCA) on reducing serum potassium levels in haemodialysis (HD) patients with hyperkalaemia.


METHODS
Prospectively, 21 HD patients with hyperkalaemia were enrolled in this study. Patients were divided into two groups, including FCA (0.1 mg/d, n = 13) administration or no treatment (control, n = 8) for 10 months. No changes in dialysis or drug regimens were made during this period. Result. There were no significant differences in the baseline characteristics and biochemical parameters between the two groups (FCA therapy and control). At 10-months after FCA therapy, serum potassium levels were not significantly different between the treatment and control groups [median value (range): 5.2 (4.4-6.0) vs 5.8 (4.8-6.3) mEq/l, P = 0.121]. However, using the Wilcoxon signed ranks test, serum potassium levels were significantly lower at the end of the 10 month time period after FCA therapy compared with serum potassium levels of the pre-treatment period [5.2 (4.4-6.0) vs 6.1 (5.3-6.8), P = 0.01]. The biochemical values, including sodium, chloride, protein, albumin, blood nitrogen, creatinine, interdialytic weight change and blood pressure, did not show significant difference in comparisons between the two groups and pre-and post-FCA therapy period.


CONCLUSIONS
FCA therapy appears to slightly decrease serum potassium value in hyperkalaemic HD patients. However, these results are insufficient to explain the effectiveness of FCA. Therefore, potentially large-scale studies with increased dose concentrations are needed to minimize the positive potassium balance in hyperkalaemic HD patients.
Kim
Dong-Min
DM
Department of Internal Medicine, Chosun University College of Medicine, 588 Susuk-dong, Dong-gu, Gwangju, 501-717, Korea.
Chung
Jong Hoon
JH
Yoon
Sung Ho
SH
Kim
Hyun Lee
HL
D000328:Adult; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D005260:Female; D005438:Fludrocortisone / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006801:Humans; D006947:Hyperkalemia / Q000188:drug therapy / Q000209:etiology*; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000209:etiology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011188:Potassium / Q000097:blood*; D006435:Renal Dialysis / Q000009:adverse effects*; D000254:Sodium-Potassium-Exchanging ATPase / Q000187:drug effects / Q000378:metabolism; D015430:Weight Gain
D000893:Anti-Inflammatory Agents; D000254:Sodium-Potassium-Exchanging ATPase; D011188:Potassium; D005438:Fludrocortisone; C034635:fludrocortisone acetate