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The effect of calcium gluconate in the treatment of hyperkalemia

Nalan Gokce Celebi Yamanoglu1, Adnan Yamanoglu2

  • 1Department of Emergency Medicine, Izmir Bozyaka Training and Research Hospital, Izmir, Turkey.

Turkish Journal of Emergency Medicine
|May 9, 2022
PubMed

Insights

Intravenous calcium gluconate effectively treated main rhythm disorders in hyperkalemia patients, but not nonrhythm ECG changes. This study clarifies calcium gluconate

Area of Science:

  • Cardiology
  • Emergency Medicine
  • Clinical Pharmacology

Background:

  • Intravenous (IV) calcium salts are standard for severe hyperkalemia cardio-protection.
  • Current recommendations lack robust evidence, relying on anecdotal support.
  • The efficacy of IV calcium gluconate in hyperkalemia treatment requires further investigation.

Purpose of the Study:

  • To evaluate the effectiveness of IV calcium gluconate in treating hyperkalemia.
  • To assess the impact of IV calcium gluconate on electrocardiogram (ECG) changes associated with hyperkalemia.

Main Methods:

  • Prospective observational study of 111 hyperkalemia patients with ECG changes.
  • ECG parameters were recorded before and after IV calcium gluconate administration.
  • Statistical analysis included Wilcoxon and McNemar's tests for ECG parameter comparison.

Main Results:

  • The mean potassium level was 7.1 ± 0.6 mmol/l.
  • IV calcium gluconate showed no significant effect on 164 nonrhythm ECG disorders (P = 0.125).
  • A statistically significant improvement (P < 0.004) was observed in 9 out of 79 main rhythm disorders.

Conclusions:

  • IV calcium gluconate demonstrates limited effectiveness in treating main rhythm ECG disorders caused by hyperkalemia.
  • The therapy was ineffective for nonrhythm ECG disorders associated with hyperkalemia.
  • Calcium gluconate's utility may be restricted to specific hyperkalemia-induced rhythm disturbances.
Abstract

Keywords:
Acidosiscalcium gluconateelectrocardiographyhyperkalemiarenal failure

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