title: High-dose calcium reduces early-onset hyperkalemia in extremely preterm neonates.
abstract: BACKGROUND
  Early-onset hyperkalemia often occurs in extremely preterm infants during a few days after birth. While there are several treatments for hyperkalemia, calcium infusion to reduce plasma potassium concentrations remains controversial. The purpose of this study is to investigate whether a high dosage of calcium reduces early-onset hyperkalemia.
  
  
  METHODS
  Extremely low-birthweight neonates born at 22-25 weeks' gestation were enrolled. We analyzed data using multivariate regression analysis and performed a retrospective cohort study with patients divided into two groups according to the dosage of calcium in their initial infusion.
  
  
  RESULTS
  A total of 103 patients were eligible. Early-onset hyperkalemia was observed in 27 patients. The dosage of calcium gluconate during 24 h after birth was the only independent factor affecting early-onset hyperkalemia. The maximum plasma potassium concentration during 72 h after birth was negatively correlated with the dosage of calcium. High-dose calcium reduced occurrences of hyperkalemia and hypoglycemia caused by insulin infusion given for treatment of hyperkalemia, without increasing the risk of any other complications.
  
  
  CONCLUSIONS
  Infusion of calcium gluconate may reduce early-onset hyperkalemia in a dose-dependent manner.
authors.affiliation: Department of Pediatrics and Neonatology, Takatsuki General Hospital, Takatsuki, Osaka, Japan. enomoto@ajk.takatsuki-hp.or.jp
authors.forename: Masahiro
authors.initials: M
authors.lastname: Enomoto
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Minami
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Takano
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Katayama
authors.forename: Yong Kye
authors.initials: YK
authors.lastname: Lee
mesh_terms: D017668:Age of Onset; D002118:Calcium / Q000097:blood*; D002125:Calcium Gluconate / Q000008:administration & dosage*; D004305:Dose-Response Relationship, Drug; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006947:Hyperkalemia / Q000097:blood / Q000188:drug therapy* / Q000453:epidemiology; D015994:Incidence; D052577:Infant, Extremely Low Birth Weight; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000097:blood / Q000188:drug therapy* / Q000453:epidemiology; D019102:Infant, Very Low Birth Weight; D007564:Japan / Q000453:epidemiology; D008297:Male; D011188:Potassium / Q000097:blood*; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D011188:Potassium; D002125:Calcium Gluconate; D002118:Calcium