Severe hyperkalaemia resulting from octreotide use in a haemodialysis patient.
A 48-year-old man, with end-stage renal disease (ESRD) on haemodialysis, presented to the emergency department with sulphonylurea-induced hypoglycaemia. His hypoglycaemia was persistent despite glucose infusion, so he was treated with octreotide. Octreotide administration reversed the hypoglycaemia but also resulted in severe hyperkalaemia. The patient was urgently dialysed, the octreotide was discontinued and his potassium normalized. We believe that the hyperkalaemia was caused by octreotide-induced insulin suppression and resultant impaired cellular potassium uptake. Although octreotide may be an effective therapy in refractory sulphonylurea-induced hypoglycaemia, it should be used with caution in patients on dialysis.
Adabala
Madhuri
M
Division of Kidney Diseases and Hypertension, Department of Medicine, North Shore/LIJ Health Systems, Hofstra University School of Medicine, Great Neck, NY, USA.
Jhaveri
Kenar D
KD
Gitman
Michael
M
D006801:Humans; D006947:Hyperkalemia / Q000139:chemically induced*; D007003:Hypoglycemia / Q000139:chemically induced / Q000188:drug therapy; D007328:Insulin / Q000378:metabolism; D000078790:Insulin Secretion; D007676:Kidney Failure, Chronic / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D015282:Octreotide / Q000009:adverse effects / Q000031:analogs & derivatives*; D006435:Renal Dialysis; D013453:Sulfonylurea Compounds / Q000037:antagonists & inhibitors
D007328:Insulin; D013453:Sulfonylurea Compounds; D015282:Octreotide