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Year 2021, Volume: 11 Issue: 3, 412 - 417, 27.09.2021
https://doi.org/10.33808/clinexphealthsci.747900

Abstract

References

  • [1] Fried L, Kovesdy CP, Palmer BF. New options for the management of chronic hyperkalemia. Kidney International (Suppl) 2017; 7: 164-70.
  • [2] Spital A, Freedman Z. Severe hypercalcemia in a woman with renal failure. American Journal of kidney Diseases 1995; 26: 674-7.
  • [3] Mushtaq MA, Masood M. Treatment of hyperkalemia with salbutamol and insulin. Pakistan Journal of Medical Sciences 2006; 22: 176.
  • [4] Allon M. Treatment and prevention of hyperkalemia in end-stage renal disease. Kidney International 1993; 43:1197-209.
  • [5] Kovesdy CP. Management of hyperkalemia in chronic kidney disease. Nature Reviews Nephrology 2014; 10: 653.
  • [6] Palmer BF. Managing hyperkalemia caused by inhibitors of the renin–angiotensin–aldosterone system. New England Journal of Medicine 2004; 351: 585-92.
  • [7] Palmer BF. Hyperkalemia in pre-dialysis patients. Clinical Journal of the American Society of Nephrology 2012; 7: 1201-2.
  • [8] Palmer BF, Clegg DJ. Achieving the benefits of a high-potassium, paleolithic diet, without the toxicity. Mayo Clinic Proceedings 2016; 91: 496-508.
  • [9] Maxwell and Kleeman. Clinical Disorders of Fluid and Electrolyte Metabolism, Fifth Edition. 1994. Robert G. Narins (Editor), Publish by McGraw-Hill, New York.
  • [10] Mann JF, Anderson C, Gao P, Gerstein HC, Boehm M, Ryden L, et al. Dual inhibition of the renin–angiotensin system in high-risk diabetes and risk for stroke and other outcomes: results of the ONTARGET trial. Journal of Hypertension 2013; 31: 414-21.
  • [11] Fried LF, Duckworth W, Zhang JH, O'Connor T, Brophy M, Emanuele N, et al. Design of combination angiotensin receptor blocker and angiotensin-converting enzyme inhibitor for treatment of diabetic nephropathy. Clinical Journal of the American Society of Nephrology 2009; 4: 361-8.
  • [12] Parving HH, Brenner BM, McMurray JJ, De Zeeuw D, Haffner SM, Solomon SD, et al. Cardiorenal end points in a trial of aliskiren for type 2 diabetes. New England Journal of Medicine 2012; 367: 2204-13.
  • [13] Vassalotti JA, Centor R, Turner BJ, Greer RC, Choi M, Sequist TD, et al. Practical approach to detection and management of chronic kidney disease for the primary care clinician. The American Journal of Medicine 2016; 129: 153-62.
  • [14] Epstein M. Hyperkalemia as a constraint to therapy with combination Renin‐Angiotensin System blockade: The elephant in the room. The Journal of Clinical Hypertension 2009; 11: 55-60.
  • [15] Liou H-H, Chiang S-S, Wu S-C, Huang T-P, Campese VM, Smogorzewski M, et al. Hypokalemic effects of intravenous infusion or nebulization of salbutamol in patients with chronic renal failure: comparative study. American Journal of kidney Diseases 1994; 23: 266-71.
  • [16] Mehta RL. Therapeutic alternatives to renal replacement for critically ill patients in acute renal failure. Seminars in Nephrology 1994; 14: 64-82.
  • [17] Rahman SN, Kim GE, Mathew AS, Goldberg CA, Allgren R, Schrier RW, et al. Effects of atrial natriuretic peptide in clinical acute renal failure. Kidney International 1994; 45: 1731.
  • [18] Allon M, Shanklin N. Effect of albuterol treatment on subsequent dialytic s potassium removal. American Journal of kidney Diseases 1995; 26: 607-13.
  • [19] Mount DB. Thick ascending limb of the loop of Henle. Clinical Journal of the American Society of Nephrology 2014; 9: 1974-86.
  • [20] Aronson PS, Giebisch G. Effects of pH on potassium: new explanations for old observations. Journal of the American Society of Nephrology 2011; 22: 1981-9.
  • [21] Li T, Vijayan A. Insulin for the treatment of hyperkalemia: a double-edged sword? Clinical kidney Journal 2014; 7: 239-41.
  • [22] Al-Azzawi OFN, Obaidy MWA, Shihab DM, The effect of nebulized salbutamol on serum potassium and blood sugar level of asthmatic patients. Global Journal of Health Science 2018; 10 (9); 25-32.
  • [23] Johns R, Roberts CM. Nebulisers: their effectiveness, indications and limitations. The Journal of Prescribing and Medicines Management 2007; 18: 16-28.
  • [24] Pandya D, Puttanna A, Balagopal V. Systemic Effects of Inhaled Corticosteroids: An Overview. The Open Respiratory Medicine Journal 2014; 8: 59.
  • [25] Sears MR, Lötvall J. Past, present and future—β2-adrenoceptor agonists in asthma management. Respiratory Medicine 2005; 99: 152-70.

Comparing the effect of insulin infusion alone and in combination of insulin infusion with salbutamol nebulization in treatment of hyperkalemia in diabetic and non-diabetic patients

Year 2021, Volume: 11 Issue: 3, 412 - 417, 27.09.2021
https://doi.org/10.33808/clinexphealthsci.747900

Abstract

Objective: To evaluate the clinical efficacy and comparison of potassium lowering effect of insulin infusion alone and insulin infusion with salbutamol nebulization.

Methods:
This interventional study was conducted in a tertiary care hospital, for a period of one year. A total of 190 patients with hyperkalemia were divided into two groups. Group-A (diabetic [D] and non-diabetic [ND] patients) received salbutamol 20 mg three times daily (TDS) (nebulizer 5mg/2.5mL) administered over a period of 15 minutes with 10 units of regular insulin (diluted with 25% dextrose in non-diabetic only) over 30 minute TDS via infusion. Group-B (diabetic and non-diabetic patients) received 10 units of regular insulin (diluted with 25% dextrose in non-diabetic patients only) administered over 30 minute TDS via infusion. Potassium and glucose level was measured in patient blood sample after 0, 6, 12 and 24 hrs of treatment.

Results:
The potassium level was decreased by 30.09% (D) and 31.98% (ND) in Group-A, whereas by 31.98% (D) and 20.49% (ND) in Group-B, after 24 hrs. Whereas blood glucose level in diabetic patients of Group-A and Group-B was found to decrease up to 28.85 % and 40.78 % respectively after 6 hours. Both the treatments were found to be effective without any complication i.e. hypoglycaemia and hypokalaemia. Moreover, renal, liver, cardiac and respiratory function test also did not show significant changes after treatments when recorded bihourly

Conclusion:
From the results, salbutamol nebulizer with insulin is more effective in the treatment of hyperkalemia in diabetic and non-diabetic patients.

References

  • [1] Fried L, Kovesdy CP, Palmer BF. New options for the management of chronic hyperkalemia. Kidney International (Suppl) 2017; 7: 164-70.
  • [2] Spital A, Freedman Z. Severe hypercalcemia in a woman with renal failure. American Journal of kidney Diseases 1995; 26: 674-7.
  • [3] Mushtaq MA, Masood M. Treatment of hyperkalemia with salbutamol and insulin. Pakistan Journal of Medical Sciences 2006; 22: 176.
  • [4] Allon M. Treatment and prevention of hyperkalemia in end-stage renal disease. Kidney International 1993; 43:1197-209.
  • [5] Kovesdy CP. Management of hyperkalemia in chronic kidney disease. Nature Reviews Nephrology 2014; 10: 653.
  • [6] Palmer BF. Managing hyperkalemia caused by inhibitors of the renin–angiotensin–aldosterone system. New England Journal of Medicine 2004; 351: 585-92.
  • [7] Palmer BF. Hyperkalemia in pre-dialysis patients. Clinical Journal of the American Society of Nephrology 2012; 7: 1201-2.
  • [8] Palmer BF, Clegg DJ. Achieving the benefits of a high-potassium, paleolithic diet, without the toxicity. Mayo Clinic Proceedings 2016; 91: 496-508.
  • [9] Maxwell and Kleeman. Clinical Disorders of Fluid and Electrolyte Metabolism, Fifth Edition. 1994. Robert G. Narins (Editor), Publish by McGraw-Hill, New York.
  • [10] Mann JF, Anderson C, Gao P, Gerstein HC, Boehm M, Ryden L, et al. Dual inhibition of the renin–angiotensin system in high-risk diabetes and risk for stroke and other outcomes: results of the ONTARGET trial. Journal of Hypertension 2013; 31: 414-21.
  • [11] Fried LF, Duckworth W, Zhang JH, O'Connor T, Brophy M, Emanuele N, et al. Design of combination angiotensin receptor blocker and angiotensin-converting enzyme inhibitor for treatment of diabetic nephropathy. Clinical Journal of the American Society of Nephrology 2009; 4: 361-8.
  • [12] Parving HH, Brenner BM, McMurray JJ, De Zeeuw D, Haffner SM, Solomon SD, et al. Cardiorenal end points in a trial of aliskiren for type 2 diabetes. New England Journal of Medicine 2012; 367: 2204-13.
  • [13] Vassalotti JA, Centor R, Turner BJ, Greer RC, Choi M, Sequist TD, et al. Practical approach to detection and management of chronic kidney disease for the primary care clinician. The American Journal of Medicine 2016; 129: 153-62.
  • [14] Epstein M. Hyperkalemia as a constraint to therapy with combination Renin‐Angiotensin System blockade: The elephant in the room. The Journal of Clinical Hypertension 2009; 11: 55-60.
  • [15] Liou H-H, Chiang S-S, Wu S-C, Huang T-P, Campese VM, Smogorzewski M, et al. Hypokalemic effects of intravenous infusion or nebulization of salbutamol in patients with chronic renal failure: comparative study. American Journal of kidney Diseases 1994; 23: 266-71.
  • [16] Mehta RL. Therapeutic alternatives to renal replacement for critically ill patients in acute renal failure. Seminars in Nephrology 1994; 14: 64-82.
  • [17] Rahman SN, Kim GE, Mathew AS, Goldberg CA, Allgren R, Schrier RW, et al. Effects of atrial natriuretic peptide in clinical acute renal failure. Kidney International 1994; 45: 1731.
  • [18] Allon M, Shanklin N. Effect of albuterol treatment on subsequent dialytic s potassium removal. American Journal of kidney Diseases 1995; 26: 607-13.
  • [19] Mount DB. Thick ascending limb of the loop of Henle. Clinical Journal of the American Society of Nephrology 2014; 9: 1974-86.
  • [20] Aronson PS, Giebisch G. Effects of pH on potassium: new explanations for old observations. Journal of the American Society of Nephrology 2011; 22: 1981-9.
  • [21] Li T, Vijayan A. Insulin for the treatment of hyperkalemia: a double-edged sword? Clinical kidney Journal 2014; 7: 239-41.
  • [22] Al-Azzawi OFN, Obaidy MWA, Shihab DM, The effect of nebulized salbutamol on serum potassium and blood sugar level of asthmatic patients. Global Journal of Health Science 2018; 10 (9); 25-32.
  • [23] Johns R, Roberts CM. Nebulisers: their effectiveness, indications and limitations. The Journal of Prescribing and Medicines Management 2007; 18: 16-28.
  • [24] Pandya D, Puttanna A, Balagopal V. Systemic Effects of Inhaled Corticosteroids: An Overview. The Open Respiratory Medicine Journal 2014; 8: 59.
  • [25] Sears MR, Lötvall J. Past, present and future—β2-adrenoceptor agonists in asthma management. Respiratory Medicine 2005; 99: 152-70.
There are 25 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Articles
Authors

Rohit Tıwarı This is me 0000-0002-4347-3786

Parmınder Naın 0000-0003-4571-3306

Jasmine Kaur This is me 0000-0001-7171-4922

Harbir Rao This is me 0000-0002-4785-9563

Jaspreet Kaur This is me 0000-0002-7753-0486

Publication Date September 27, 2021
Submission Date June 4, 2020
Published in Issue Year 2021 Volume: 11 Issue: 3

Cite

APA Tıwarı, R., Naın, P., Kaur, J., Rao, H., et al. (2021). Comparing the effect of insulin infusion alone and in combination of insulin infusion with salbutamol nebulization in treatment of hyperkalemia in diabetic and non-diabetic patients. Clinical and Experimental Health Sciences, 11(3), 412-417. https://doi.org/10.33808/clinexphealthsci.747900
AMA Tıwarı R, Naın P, Kaur J, Rao H, Kaur J. Comparing the effect of insulin infusion alone and in combination of insulin infusion with salbutamol nebulization in treatment of hyperkalemia in diabetic and non-diabetic patients. Clinical and Experimental Health Sciences. September 2021;11(3):412-417. doi:10.33808/clinexphealthsci.747900
Chicago Tıwarı, Rohit, Parmınder Naın, Jasmine Kaur, Harbir Rao, and Jaspreet Kaur. “Comparing the Effect of Insulin Infusion Alone and in Combination of Insulin Infusion With Salbutamol Nebulization in Treatment of Hyperkalemia in Diabetic and Non-Diabetic Patients”. Clinical and Experimental Health Sciences 11, no. 3 (September 2021): 412-17. https://doi.org/10.33808/clinexphealthsci.747900.
EndNote Tıwarı R, Naın P, Kaur J, Rao H, Kaur J (September 1, 2021) Comparing the effect of insulin infusion alone and in combination of insulin infusion with salbutamol nebulization in treatment of hyperkalemia in diabetic and non-diabetic patients. Clinical and Experimental Health Sciences 11 3 412–417.
IEEE R. Tıwarı, P. Naın, J. Kaur, H. Rao, and J. Kaur, “Comparing the effect of insulin infusion alone and in combination of insulin infusion with salbutamol nebulization in treatment of hyperkalemia in diabetic and non-diabetic patients”, Clinical and Experimental Health Sciences, vol. 11, no. 3, pp. 412–417, 2021, doi: 10.33808/clinexphealthsci.747900.
ISNAD Tıwarı, Rohit et al. “Comparing the Effect of Insulin Infusion Alone and in Combination of Insulin Infusion With Salbutamol Nebulization in Treatment of Hyperkalemia in Diabetic and Non-Diabetic Patients”. Clinical and Experimental Health Sciences 11/3 (September 2021), 412-417. https://doi.org/10.33808/clinexphealthsci.747900.
JAMA Tıwarı R, Naın P, Kaur J, Rao H, Kaur J. Comparing the effect of insulin infusion alone and in combination of insulin infusion with salbutamol nebulization in treatment of hyperkalemia in diabetic and non-diabetic patients. Clinical and Experimental Health Sciences. 2021;11:412–417.
MLA Tıwarı, Rohit et al. “Comparing the Effect of Insulin Infusion Alone and in Combination of Insulin Infusion With Salbutamol Nebulization in Treatment of Hyperkalemia in Diabetic and Non-Diabetic Patients”. Clinical and Experimental Health Sciences, vol. 11, no. 3, 2021, pp. 412-7, doi:10.33808/clinexphealthsci.747900.
Vancouver Tıwarı R, Naın P, Kaur J, Rao H, Kaur J. Comparing the effect of insulin infusion alone and in combination of insulin infusion with salbutamol nebulization in treatment of hyperkalemia in diabetic and non-diabetic patients. Clinical and Experimental Health Sciences. 2021;11(3):412-7.

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