Treatment of hyperkalaemia in renal failure with salbutamol inhalation

The aim of this study was to investigate whether beta-2-adrenergic stimulation with inhaled salbutamol is therapeutically useful in hyperkalaemia. Ten patients with renal failure and hyperkalaemia (serum potassium concentration greater than 6 mmol l-1) were given 15 mg salbutamol via a nebulizer over a 30-min period. Serum potassium was measured 30, 60, 180 and 360 min thereafter. All patients had end-stage renal failure on chronic hospital haemodialysis. Serum potassium levels decreased significantly from a pretreatment value of 6.5 +/- 0.6 mmol l-1 to 5.6 +/- 0.6 mmol-1 after 30 min, and this level was maintained for 3 h. Six hours after treatment, the serum potassium concentration was 6 +/- 0.7 mmol l-1. There was a modest increase in heart rate and blood glucose level, but otherwise salbutamol was well tolerated and no serious side-effects occurred. It is concluded that the administration of salbutamol by inhalation is a simple, safe and reasonably effective method for treatment of hyperkalaemia in renal failure.