Original InvestigationDialysis TherapyA Randomized Controlled Trial of Fludrocortisone for the Treatment of Hyperkalemia in Hemodialysis Patients
Section snippets
Study Subjects
All adult patients receiving in-center hemodialysis at the Princess Alexandra Hospital (Brisbane, Australia) or Logan Hospital (Logan City, Australia) were invited to participate in the study if they met the following inclusion criteria: (1) 18 years or older, (2) midweek predialysis potassium concentration greater than 4.5 mEq/L (>4.5 mmol/L; the upper reference limit for the laboratory) and less than 7.0 mEq/L (<7.0 mmol/L) during the 3 months before study commencement, and (3) able to give
Results
Numbers of patients who entered the study, were assigned to a study group, and completed the protocol are shown in Fig 1. Thirty-seven of 41 patients who entered the study completed the study protocol and were included in the intention-to-treat analysis (18 patients, fludrocortisone group; 19 patients, control group). Baseline demographics of the 2 groups were similar, except for longer dialysis hours in the fludrocortisone cohort (Table 1).
At the end of the 3-month study period, midweek
Discussion
Results of the present study show that administering fludrocortisone to hyperkalemic hemodialysis patients is safe and well tolerated, but does not achieve decreases in serum potassium levels that are either statistically significant or clinically important. To our knowledge, this is the only randomized controlled trial of fludrocortisone administration for the treatment of hyperkalemia in hemodialysis patients.
Results of this study differ from those of 3 previous uncontrolled studies, which
Acknowledgment
The authors thank the nursing staff of the Princess Alexandra Hospital Haemodialysis Unit for their invaluable assistance.
References (10)
- et al.
Effect of various therapeutic approaches on plasma potassium and major regulating factors in terminal renal failure
Am J Med
(1988) - et al.
Mechanism and prevention of cardiac arrhythmias in chronic hemodialysis patients
Kidney Int
(1980) - et al.
Safety and efficacy of low-potassium dialysate
Am J Kidney Dis
(1989) - et al.
Cardiac arrest and sudden death in dialysis units
Kidney Int
(2001) - et al.
Temporal profile of serum potassium concentration in nondiabetic and diabetic outpatients on chronic dialysis
Am J Nephrol
(1987)
Cited by (0)
Originally published online as doi:10.1053/j.ajkd.2006.01.014 on March 17, 2006.
Support: None. Potential conflicts of interest: None.