21^st Global Nephrology, Urology and Kidney Failure Congress

Biography

Biography: R. Michael Culpepper

Abstract

Hyperkalemia occurs with intense exercise in individuals with normal renal function. Exercise is deemed beneficial to patients on hemodialysis to forestall frailty and  improve overall well-being. We examined the magnitude of rise in serum [K+], any accompanying electrocardiographic effects and hemodynamics in functionally anephric hemodialysis patients subject to brief, exhaustive exercise. The time course of changes in [K+] in both venous blood and arterial blood were charted and correlated  to changes in arterial pH, blood glucose, blood glucose, serum [Na+] and hematocrit. The study was approved  by the Committee for Protection  of Human Subjects andl participants gave their written informed consent. None of the subjects has known active cardiac disease and none were taking β-adrenergic blocking agents, digitalis preparations or potassium sparing drugs.   Arterial [K+] peaked at 3.5 minutes with a mean  rise of 1.67 mEq/L. Venous [K+] peaked  about 1 minute earlier, averaging 0.84 mEq/L increase yielding a mean A-V difference in [K+] of 0.81 mEq/L. All values returned to baseline within 3 minutes of rest. There were significant falls in arterial pH averaging  -0.15u and rises in serum lactate with a mean increase of 8.14 mmol/L at 5 minutes. Changes in serum glucose, insulin, serum [Na+] and hematocrit were insignificant throughout the study. We conclude that  resting skeletal muscle buffers rises in exercise-induced hyperkalemia in hemodialysis patients as has seen in normal persons.