The Influence of Nonselective Beta-Adrenergic Blockade (carteolol) and ACE Inhibitor (captopril) in Plasma Potassium on Maintenance hemodialysis.
- Author:
Jae Ung LEE
1
;
Oh Young LEE
;
Suck Chul YANG
;
Dong Soo HAN
;
Joo Hyun SOHN
;
Soon Kil KIM
;
Ho Jung KIM
;
Hee Kwan KOH
;
Ja Hun JUNG
;
Seung Woo NAM
;
In Kyu PAIK
;
Chang Beom LEE
Author Information
1. Department of Internal Medicine, College of Medicine, Hanyang University, Kuri, Korea.
- Publication Type:Original Article
- Keywords:
Hyperkalemia;
Hemodialysis;
Beta-adrenergic blocker;
ACE inhibitor
- MeSH:
Adult;
Blood Gas Analysis;
Carteolol;
Dialysis;
Female;
Glomerulonephritis;
Glucose;
Humans;
Hydrogen-Ion Concentration;
Hyperkalemia;
Kidney Failure, Chronic;
Kinetics;
Male;
Plasma*;
Potassium*;
Renal Dialysis*;
Sodium
- From:Korean Journal of Medicine
1997;52(2):149-155
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
OBJECTIVES: The degree of hyperkalemia and effects of potassium removal by hemodialysis on the plasma potassium concentration to see the influence of nonselective beta-adrenergic blockade(carteolol) and ACE inhibitor(captopril) on patients in maintenance hemodialysis were evaluated. METHODS: This study was done on 16 patients with end-stage renal disease undergoing maintenance hemodialysis. These patients were classified two groups; group 1-patients with carteolol or captopril(9 patients) and group 2-patients without medication(7 patients). Measurement of plasma potassium and arterial blood gas analyses were performed at pre-dialysis and during hemodialysis(4 hours). To analysis the distribution of potassium kinetics during hemodialysis, dialysis potassium clearance rate was introduced in this study. RESULTS: 1) Among 16 patients studied, the mean age was 43 years old and the ratio of male to female was 2: 1 and the mean duration of hemodialysis was 17.9 months. The underlying cause of end-stage renal disease was chronic glomerulonephritis in the most patients. 2) The mean predialysis plasma potassium concentration of all patients, group 1 on medication, and group 2 without medication was 5.13 +/- 1.04mEq/L, 5.67 +/- 1.01mEq/L and 4.410.55mEq/L, with high significance(p<0.001) between groups 1 and 2. 3) The mean postdialysis plasma potassium concentration of group 1 on medication and group 2 without medication was 348 +/- 0.40mEq/L and 3.39 +/- 0.56mEq/L with insignificance between groups 1 and 2. 4) The pre- and post-dialysis concentration of plasma sodium, pH and bicarbonate between group 1 and group 2 was similar except glucose. 5) Despite the fall in absolute plasma concentration in group 1 more than twice than in group 2, the difference in dialysis potassium clearance rate measured at 1 hour of hemodialysis in group 1 compared to that of group 2 was only 12M. CONCLUSION: These data are consistent with at least a two-compartment distribution of plasma potassium rather than single pool in addition to frequent hyperkalemia on maintenance hemodialysis on nonselective beta-adrenergic blocker or ACE inhibitor contributed to partial impairment of extrarenal transcellular shifts of potassium during inter- and intra-dialytic phase.
