Bolus administration of intravenous glucose in the treatment of hyperkalemia : a randomized controlled trial

Please cite as follows:Chothia, M-Y. et al. 2014. Bolus Administration of Intravenous Glucose in the Treatment of Hyperkalemia: A Randomized Controlled Trial. Nephron Physiology, 1(26):1-8, doi:10.1159/000358836.The original publication is available at http://www.karger.com/Journal/Issue/261595Background: Hyperkalemia is a common medical emergency that may result in serious cardiac arrhythmias. Standard therapy with insulin plus glucose reliably lowers the serum potassium concentration ([K + ]) but carries the risk of hypoglycemia. This study examined whether an intravenous glucose- only bolus lowers serum [K + ] in stable, nondiabetic, hyperkalemic patients and compared this intervention with insulin-plus-glucose therapy. Methods: A randomized, crossover study was conducted in 10 chronic hemodialysis patients who were prone to hyperkalemia. Administration of 10 units of insulin with 100 ml of 50% glucose (50 g) was compared with the administration of 100 ml of 50% glucose only. Serum [K + ] was measured up to 60 min. Patients were monitored for hypoglycemia and EKG changes. Results: Baseline serum [K + ] was 6.01 ± 0.87 and 6.23 ± 1.20 mmol/l in the insulin and glucose-only groups, respectively (p = 0.45). At 60 min, the glucose-only group had a fall in [K + ] of 0.50 ± 0.31 mmol/l (p < 0.001). In the insulin group, there was a fall of 0.83 ± 0.53 mmol/l at 60 min (p < 0.001) and a lower serum [K + ] at that time compared to the glucose-only group (5.18 ± 0.76 vs. 5.73 ± 1.12 mmol/l, respectively; p = 0.01). In the glucose-only group, the glucose area under the curve (AUC) was greater and the insulin AUC was smaller. Two patients in the insulin group developed hypoglycemia. Conclusion: Infusion of a glucose-only bolus caused a clinically significant decrease in serum [K + ] without any episodes of hypoglycemia.Post-prin

Stay cool, hang loose, admit nothing: Race, intergroup contact, and public-police relations

Drawing on the contact hypothesis of Allport (1954) and Pettigrew (1998) we examined whether public-police contact, among White and Black university students in Britain, mediated between participant race and perceived racism of police and cooperation with police, respectively. Study 1 (N= 105) showed this to be the case for quality, but not quantity of contact. High-quality contact mitigated the negative effects of being Black on greater perceived racism and lower cooperation. Study 2 (N= 130) assessed a general view of police and desired closeness to police as dependent variables and investigated the moderating potential of racial identification. Higher-quality and lower quantity of contact were associated with a more positive view of police and higher desired closeness. Identification moderated the effects of race on quantity of contact, view of police, and desired closeness, with negative effects driven by high identification