Hypoglycemia in the treatment of hyperkalemia in ESRD frequently happens! There ae growing in the body of literature to address this issue with different recommendations:
- administering 25 g of dextrose with insulin and 25 g of dextrose 1 h after insulin based on our result that hypoglycemia occurred 1–3 h after insulin with dextrose. Link to article
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The dextrose may be administered as 100 ml of 50% dextrose IVP or 50 ml of 50% dextrose IVPB, followed by 250 ml ofD10 IVPB over 1 hour. Link to article
- ISMP Medication Safety Alert
Argument for Low dose vs high dose Insulin induced hypoglycemia in the management of hyperkalemia