ORAL GLUCOSE LOADS AND POTASSIUM LEVELS I N PATIENTS ON HEMODIALYSIS

Elevated plasma potassium (Kp) is still a significant cause of morbidi ty and mortality in hemodialysis (HD) patients. Therefore, practical, self-administrable treatments are necessary, aimed to rapidly decrease Kp levels. The objective of the present study was to test the effect of oral glucose and the subsequent endogenous insulin stimulation on K p, in a group of HD patients and matched, normal controls. A glucose l oad (75 g) was administered at 8 AM, after overnight fasting, and afte r a dialysis-free weekend Several variables were simultaneously measur ed. The decrease in Kp between 0 and 120 min was significantly lower ( 0.31 +/- 0.07 mEq/L, n = 8; p < 0.05) in HD patients compared to contr ols (0.48 +/- 0.03, n = 8). However, no differences were found in the insulin levels between both groups. The slope of the change of Kp as a function of the change of insulin was also significantly different in both groups (HD = 35.4, control = 4.9, p < 0.05). No changes were det ected with the glucose load on ECG patterns, blood pH or osmolality. I n conclusion: a) an oral glucose load significantly reduces Kp, howeve r, the small amount of such kp reduction and the 120 min required to r each the nadir of Kp levels, suggest that the oral glucose load is not a useful tool to eliminate clinical complications depending on high K p; b) in HD patients, there may be a significant reduction in the effi cacy of endogenous insulin to redistribute K toward the intracellular space.