Abstract
β2-agonists are commonly used for the treatment of hyperkalemia in the USA and Europe due to their potassium lowering effect. However, only one report on the use of β2-agonists for hyperkalemia has been published in Japan. We studied the effect of an inhalation of a β2-agonist, salbutamol, on serum potassium in 1 adult and 4 pediatric patients with acute renal failure and hyperkalemia(≥5.5mEq/L). Each patient inhaled 100μg/kg salbutamol, and blood samples were obtained after 30 min and after 4h from 2 patients and after 4 h from 3 patients. From 30min to 2h after the inhalation, sodium polystyrene sulfonate was given to 4 patients, and insulin and glucose was administered to 1 patient. In 2 patients, 30min after inhalation, serum potassium levels decreased from 6.3 to 6.0mEq/L and from 6.9 to 6.0mEq/L, respectively. The median serum potassium of the 5 patients declined significantly from 6.3mEq/L (range 5.5-7.4) to 5.2mEq/L (range 4.6-7.0) 4h aadverse effects of salbutamol were observed. Salbutamol inhalation appears to be a safe and efficacious primary treatment for hyperkalemia in children.
