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      Nonselective Beta-Adrenergic Blockade Augments Fasting Hyperkalemia in Hemodialysis Patients

      ,

      Nephron

      S. Karger AG

      Fasting, Hemodialysis, Hyperkalemia, Terminal renal failure, β-Adrenergic blockers

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          Abstract

          Background/Aim: Fasting hyperkalemia in patients with end-stage renal failure is a well-documented phenomenon. Both a decreased secretion of insulin and decreased β-adrenergic receptor sensitivity may take part in this effect. Methods: Twelve anuric, long-term (6.4 ± 2.7 years; mean ± SD) hemodialysis patients underwent three periods of 18-hour fasting (from 6 p.m. to 12 a.m.). At the beginning of each fasting period a single dose of the nonselective β-blocker, nadolol (80 mg), or the β<sub>1</sub>-selective blocker, betaxolol (20 mg), or placebo were given in a random order and in blinded fashion. The wash-out period was 7 days. Results: The mean decrease in blood pressure was similar after nadolol and betaxolol (18 ± 10 vs. 19 ± 11 mm Hg) as was a decrease in heart rate (20 ± 3 and 19 ± 6, respectively). Serum potassium was not different before each of the fasting periods. The increase in serum potassium during fasting was highly significant in each case. The mean increase in serum potassium was 1.2 ± 0.4 mmol/l after nadolol, 0.9 ± 0.6 after betaxolol and 0.6 ± 0.6 after placebo. This effect was significantly larger after nadolol than after placebo (p = 0.01), but this relation was not significant with respect to betaxolol (p = 0.30). Serum insulin as well as glucose decreased significantly and to a similar extent during each fasting period. Plasma aldosterone was unchanged. Conclusion: Nonselective β-adrenergic blockade increases the hyperkalemic effect of fasting in hemodialysis patients.

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          Author and article information

          Journal
          NEF
          Nephron
          10.1159/issn.1660-8151
          Nephron
          S. Karger AG
          1660-8151
          2235-3186
          2002
          June 2002
          03 June 2002
          : 91
          : 2
          : 222-227
          Affiliations
          Department of Nephrology, Polish Mother’s Memorial Hospital Research Institute, Łódź, Poland
          Article
          58396 Nephron 2002;91:222–227
          10.1159/000058396
          12053057
          © 2002 S. Karger AG, Basel

          Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

          Page count
          Figures: 1, Tables: 1, References: 24, Pages: 6
          Product
          Self URI (application/pdf): https://www.karger.com/Article/Pdf/58396
          Categories
          Original Paper

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