Therapy

Consider combining with hypertonic sodium bicarbonate at 2 mmol/ min for one hour. ^b

Why?

• Hypertonic sodium bicarbonate increases the potassium-lowering effect of insulin and glucose by 0.5 mmol/l when given over 1 hour in hyperkalaemic patients with end-stage renal disease on maintenance haemodialysis ^b
• Isotonic bicarbonate infusions have no clear effect when given over 1 hour in patients with end-stage renal disease on maintenance haemodialysis ^b
• Sodium bicarbonate iv has no effect alone ^d