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      Nonselective Beta-Adrenergic Blockade Augments Fasting Hyperkalemia in Hemodialysis Patients



      S. Karger AG

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

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          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

          S. Karger AG
          June 2002
          03 June 2002
          : 91
          : 2
          : 222-227
          Department of Nephrology, Polish Mother’s Memorial Hospital Research Institute, Łódź, Poland
          58396 Nephron 2002;91:222–227
          © 2002 S. Karger AG, Basel

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