Intravenous labetolol can precipitate life-threatening hyperkalemia in hemodialysis patients, requiring caution when treating hypertensive emergencies in this population.
May warrant caution with IV labetalol in hemodialysis patients; single case leaves broader risk unconfirmed.
Intravenous labetolol, a nonselective alpha- and beta-blocking drug, is commonly used to treat severe hypertension. Nonselective beta-blockers can cause hyperkalemia, especially in patients with renal failure. One series reported 3 renal transplant patients who had hyperkalemia after labetolol infusion, but none of these patients developed any serious complication. We report a case of life-threatening hyperkalemia (serum [K+] 9.9 mEq/l) with ventricular tachycardia and hypotension in a patient on maintenance hemodialysis who received labetolol for a hypertensive emergency. Physicians should be aware of this potentially lethal complication, which is easily preventable.
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Hamad et al. (2001) studied this question.
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