GLUCOSE MODULATION OF THE DISPOSAL OF AN ACUTE POTASSIUM LOAD IN PATIENTS WITH END-STAGE RENAL-DISEASE
GLUCOSE MODULATION OF THE DISPOSAL OF AN ACUTE POTASSIUM LOAD IN PATIENTS WITH END-STAGE RENAL-DISEASE
复制标题
DOI：
10.1016/0002-9343(93)90081-y
复制
发表时间：
1993-05-01
影响因子：
5.9
通讯作者：
SHANKLIN, N
中科院分区：
文献类型：
--
作者：
ALLON, M;DANSBY, L;SHANKLIN, N
目的：肾外钾处理在急性钾负荷的耐受性中起着重要作用，对肾功能衰竭患者尤其重要。众所周知，胰岛素通过促进细胞对钾的吸收来刺激这种处置。由于膳食中的钾通常是与碳水化合物一起摄入的，内源性胰岛素释放的可预见刺激可能会削弱血浆钾的预期增加。本研究的目的是评估口服葡萄糖对血液透析患者和正常对照组急性口服钾负荷的影响。患者和方法：8名血液透析患者和8名正常对照组在隔夜禁食后进行研究。每个受试者都接受了口服氯化钾灵丹妙剂(0.25 mm o l/kg)。在基础状态下，每隔30分钟测定血钾，持续3小时。在另一个单独的研究日，受试者接受相同的方案，在钾负荷中添加50克口服葡萄糖以刺激内源性胰岛素释放。在心得安同时阻断β-受体阻滞剂期间，在每个受试者中重复相同的两个实验方案。结果：血透患者血钾负荷后血钾最大升高值明显高于对照组(0.93+/-0.08和0.52+/-0.04 mm ol/L，P
PURPOSE: Extrarenal potassium disposal plays an important role in the tolerance of an acute potassium load and is particularly critical in patients with renal failure. Insulin is known to stimulate this disposal by enhancing potassium uptake into the cells. Since dietary potassium is generally ingested in combination with carbohydrates, the predictable stimulation of endogenous insulin release may blunt the expected increase in plasma potassium. The goal of the current study was to evaluate the effect of oral glucose on the disposition of an acute oral potassium load in hemodialysis patients and in normal controls. PATIENTS AND METHODS: Eight hemodialysis patients and eight normal control subjects were studied after an overnight fast. Each subject received an oral load of potassium chloride elixir (0.25 mmol/kg). Plasma potassium was measured at baseline and at 30-minute intervals for 3 hours. On a separate study day, the subjects underwent the identical protocol, with the addition of 50 g of oral glucose to the potassium load to stimulate endogenous insulin release. The identical two experimental protocols were repeated in each subject during concomitant beta blockade with propranolol. RESULTS: The maximal increase in plasma potassium after the potassium load was significantly greater in the hemodialysis patients than in the controls (0.93 +/- 0.08 versus 0.52 +/- 0.04 mmol/L, p