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NDT Advance Access originally published online on July 5, 2007
Nephrology Dialysis Transplantation 2007 22(11):3273-3276; doi:10.1093/ndt/gfm386
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© The Author [2007]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org


Effect of fludrocortisone acetate on reducing serum potassium levels in patients with end-stage renal disease undergoing haemodialysis

Dong-Min Kim, Jong Hoon Chung, Sung Ho Yoon and Hyun Lee Kim

Department of Internal Medicine, Chosun University College of Medicine, Gwangju, Republic of Korea

Correspondence and offprint requests to: Hyun Lee Kim, MD. Assistant professor, Department of Internal Medicine, Chosun University College of Medicine, 588 Susuk-dong, Dong-gu, Gwangju, 501-717, Korea. Email: hyunkim{at}chosun.ac.kr



  Abstract

Background. Hyperkalaemia is a commonly encountered problem in dialysis patients with end-stage renal disease (ESRD). The aim of the present study was to assess the effect of fludrocortisone acetate (FCA) on reducing serum potassium levels in haemodialysis (HD) patients with hyperkalaemia.

Methods. Prospectively, 21 HD patients with hyperkalaemia were enrolled in this study. Patients were divided into two groups, including FCA (0.1 mg/d, n = 13) administration or no treatment (control, n = 8) for 10 months. No changes in dialysis or drug regimens were made during this period.

Result. There were no significant differences in the baseline characteristics and biochemical parameters between the two groups (FCA therapy and control). At 10-months after FCA therapy, serum potassium levels were not significantly different between the treatment and control groups [median value (range): 5.2 (4.4–6.0) vs 5.8 (4.8–6.3) mEq/l, P = 0.121]. However, using the Wilcoxon signed ranks test, serum potassium levels were significantly lower at the end of the 10 month time period after FCA therapy compared with serum potassium levels of the pre-treatment period [5.2 (4.4–6.0) vs 6.1 (5.3–6.8), P = 0.01]. The biochemical values, including sodium, chloride, protein, albumin, blood nitrogen, creatinine, interdialytic weight change and blood pressure, did not show significant difference in comparisons between the two groups and pre-and post-FCA therapy period.

Conclusions. FCA therapy appears to slightly decrease serum potassium value in hyperkalaemic HD patients. However, these results are insufficient to explain the effectiveness of FCA. Therefore, potentially large-scale studies with increased dose concentrations are needed to minimize the positive potassium balance in hyperkalaemic HD patients.

Keywords: dialysis; fludrocortisone acetate; hyperkalaemia

Received for publication: 10. 1.07
Accepted in revised form: 24. 5.07


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