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Updated: May 19, 2026

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Published on: February 18, 2012
High-dose calcium reduces early-onset hyperkalemia in extremely preterm neonates
Masahiro Enomoto1, Hirotaka Minami, Tsutomu Takano
1Department of Pediatrics and Neonatology, Takatsuki General Hospital, Takatsuki, Osaka, Japan. enomoto@ajk.takatsuki-hp.or.jp
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.
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