Nephrology Dialysis Transplantation, Vol 12, Issue 8 1629-1634, Copyright © 1997 by Oxford University Press
A Blumberg, H Roser, C Zehnder and J Muller-Brand
Background: Chronic haemodialysis (HD) patients may
present with severe predialysis hyperkalaemia which is improved by dialytic
treatment. However, factors influencing the behaviour of postdialysis
plasma potassium (plasma K) are not well known.
Method: In this prospective study 14 patients (7
female, 7 male) on chronic HD were investigated during a standardized 4-h
HD with a 2 m2 high-flux dialyser and up to 6 h
postdialysis. Dialytic potassium removal was measured by dialysate
collection. Total body potassium (TBK) was measured by whole-body counting
of 40K. Results: Plasma K
declined from 5.65 to 3.62 mmol/l of HD. In spite of a total dialytic
removal of 107 mmol of potassium plasma K rose to 5.01 mmol/16 h
postdialysis. TBK, as adjusted for age, was 38.2 and 49.0 mmol/kg B2 in
female and male patients respectively, i.e. in the normal range. Of a total
potassium removal of 107 mmol on HD only 42% originated from the
extracellular space. Dialytic potassium removal was best correlated with
removal of intracellular potassium but also with extracellular potassium
content and with the product of plasma K x TBK. The 6-h postdialysis plasma
K was correlated with the predialysis value but not with TBK or dialytic
potassium removal. Conclusion: A rather high dialytic
removal of potassium (which is correlated with plasma K x TBK) does not
necessarily prevent a rapid postdialysis rebound of plasma K. Therefore
patients with marked hyperkalaemia should be monitored closely
postdialysis. TBK can be normal in haemodialysis patients who are well
nourished. Keywords: hyperkalemia; plasma potassium;
potassium removal on haemodialysis; total body potassium
ORIGINAL ARTICLES
Plasma potassium in patients with terminal renal failure during and after haemodialysis; relationship with dialytic potassium removal and total body potassium
Department of Medicine, Kantonsspital Aarau Institute of Nuclear Medicine, Kantonsspital Basel, Switzerland; Corresponding author at: Nephrologie, Kantonsspital Aarau, 5000 Aaru, Switzerland
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