Subcutaneous terbutaline use in CKD to reduce potassium concentrations

Kevin M. Sowinski, Donald Cronin, Bruce A. Mueller, Michael Kraus

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Background: Acute hyperkalemia is a frequent and potentially life-threatening medical problem in patients on maintenance hemodialysis therapy. β-Adrenergic receptor (βAR) stimulation causes potassium cellular influx and a decline in plasma potassium concentrations. Therefore, βAR agonists are used in the treatment of patients with hyperkalemia. The goal of this study is to evaluate the utility of weight-based subcutaneous terbutaline dosing to reduce plasma potassium concentrations in a group of subjects with chronic kidney disease (CKD) requiring hemodialysis. Methods: Fourteen subjects with CKD receiving long-term hemodialysis were administered terbutaline, 7 μg/kg, subcutaneously. Heart rate measurements and blood samples for potassium concentration determinations were made serially for 420 minutes. Effects of terbutaline on heart rate and potassium responses were determined in each subject. Results: Terbutaline significantly reduced plasma potassium concentrations and significantly increased heart rates during the time course of the study (P <0.001, repeated-measures analysis of variance). Mean reduction in peak potassium concentration (-1.31 ± 0.5 [SD] mEq/L) and increase in peak heart rate (25.8 ± 10.5 beats/min) were significantly different from baseline (P <0.001, baseline versus peak for both responses). No subject reported significant adverse effects. Conclusion: Administration of subcutaneous terbutaline obviates the need for intravenous access and should be considered as an alternative to nebulized or inhaled β-agonists to treat acute hyperkalemia in patients with CKD. As with the use of any β-adrenergic agonist, close cardiovascular monitoring is necessary to avoid or minimize toxicity during therapy.

Original languageEnglish (US)
Pages (from-to)1040-1045
Number of pages6
JournalAmerican Journal of Kidney Diseases
Volume45
Issue number6
DOIs
StatePublished - Jun 2005
Externally publishedYes

Fingerprint

Terbutaline
Chronic Renal Insufficiency
Potassium
Hyperkalemia
Heart Rate
Renal Dialysis
Adrenergic Agonists
Adrenergic Receptors
Analysis of Variance
Therapeutics
Maintenance
Weights and Measures

Keywords

  • Chronic kidney disease (CKD)
  • Hyperkalemia
  • Terbutaline

ASJC Scopus subject areas

  • Nephrology

Cite this

Subcutaneous terbutaline use in CKD to reduce potassium concentrations. / Sowinski, Kevin M.; Cronin, Donald; Mueller, Bruce A.; Kraus, Michael.

In: American Journal of Kidney Diseases, Vol. 45, No. 6, 06.2005, p. 1040-1045.

Research output: Contribution to journalArticle

Sowinski, Kevin M. ; Cronin, Donald ; Mueller, Bruce A. ; Kraus, Michael. / Subcutaneous terbutaline use in CKD to reduce potassium concentrations. In: American Journal of Kidney Diseases. 2005 ; Vol. 45, No. 6. pp. 1040-1045.
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