High-dose calcium reduces early-onset hyperkalemia in extremely preterm neonates.

Abstract

BACKGROUND:

Early-onset hyperkalemia often occurs in extremely preterm infants during a few days after birth. While there are several treatments for hyperkalemia, calcium infusion to reduce plasma potassium concentrations remains controversial. The purpose of this study is to investigate whether a high dosage of calcium reduces early-onset hyperkalemia.

METHODS:

Extremely low-birthweight neonates born at 22-25 weeks' gestation were enrolled. We analyzed data using multivariate regression analysis and performed a retrospective cohort study with patients divided into two groups according to the dosage of calcium in their initial infusion.

RESULTS:

A total of 103 patients were eligible. Early-onset hyperkalemia was observed in 27 patients. The dosage of calcium gluconate during 24 h after birth was the only independent factor affecting early-onset hyperkalemia. The maximum plasma potassium concentration during 72 h after birth was negatively correlated with the dosage of calcium. High-dose calcium reduced occurrences of hyperkalemia and hypoglycemia caused by insulin infusion given for treatment of hyperkalemia, without increasing the risk of any other complications.

CONCLUSIONS:

Infusion of calcium gluconate may reduce early-onset hyperkalemia in a dose-dependent manner.

• Authors: Masahiro Enomoto, Hirotaka Minami, Tsutomu Takano, Yoshinori Katayama, Yong Kye Lee
• Journal: Pediatrics international : official journal of the Japan Pediatric Society (Pediatr Int) Vol. 54 Issue 6 Pg. 918-22 (Dec 2012) ISSN: 1442-200X [Electronic] Australia
• PMID: 22924991 (Publication Type: Comparative Study, Journal Article)
• Copyright: © 2012 The Authors. Pediatrics International © 2012 Japan Pediatric Society.

Chemical References

• Potassium
• Calcium Gluconate
• Calcium

Topics

• Age of Onset
• Calcium (blood)
• Calcium Gluconate (administration & dosage)
• Dose-Response Relationship, Drug
• Female
• Follow-Up Studies
• Humans
• Hyperkalemia (blood, drug therapy, epidemiology)
• Incidence
• Infant, Extremely Low Birth Weight
• Infant, Newborn
• Infant, Premature, Diseases (blood, drug therapy, epidemiology)
• Infant, Very Low Birth Weight
• Japan (epidemiology)
• Male
• Potassium (blood)
• Retrospective Studies
• Treatment Outcome