Lower Vs. Standard Insulin-Dextrose Doses for Treating Mild to Moderate Hyperkalemia in the Emergency Department

Launched by UNIVERSITY OF MALAYA · Dec 6, 2024

Keywords

ClinConnect Summary

This clinical trial is studying how effective and safe lower doses of insulin and dextrose are for treating mild to moderate hyperkalemia, which means having higher than normal potassium levels in the blood. The trial will compare two different treatment regimens: one with 5 units of insulin and 25 mL of dextrose against a standard dose of 10 units of insulin and 50 mL of dextrose. The goal is to see if the lower dose can still effectively lower potassium levels without causing low blood sugar or other complications. This study will take place in the emergency department, and participants will be monitored for 6 hours after receiving the treatment.

To be eligible for this trial, you need to be an adult over 18 years old and have potassium levels between 5.7 and 6.4 mmol/L. However, individuals who are very unstable, have certain serious conditions like diabetic ketoacidosis, or require specific treatments will not be included. Participants can expect to have their potassium and blood sugar levels checked at various intervals during their time in the emergency department. This research aims to provide valuable information on whether lower doses can be just as effective, which could help improve treatment options for patients with hyperkalemia in the future.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • Adult patient \>18 years old in emergency department (ED) with serum potassium 5.7 mmol/L to 6.4 mmol/L for non-haemolysed serum sample
• Exclusion Criteria:
• • Adolescent/ paediatric age group
• • Patients who are in diabetic ketoacidosis (DKA) or hyperosmolar hyperglycemic state (HHS)
• • Pre-treatment blood glucose less than 4 mmol/L
• • Requiring intraveneous (IV) infusion of insulin, nebulised salbutamol and IV sodium bicarbonate during screening
• • Patient requiring resuscitation (ie: hemodynamically unstable) or requiring high flow oxygen (face mask \> 5L/min) or Modified Early Warning Score \> 4 during recruitment.