Severe hyperkalaemia resulting from octreotide use in a haemodialysis patient

Abstract

A 48-year-old man, with end-stage renal disease (ESRD) on haemodialysis, presented to the emergency department with sulphonylurea-induced hypoglycaemia. His hypoglycaemia was persistent despite glucose infusion, so he was treated with octreotide. Octreotide administration reversed the hypoglycaemia but also resulted in severe hyperkalaemia. The patient was urgently dialysed, the octreotide was discontinued and his potassium normalized. We believe that the hyperkalaemia was caused by octreotide-induced insulin suppression and resultant impaired cellular potassium uptake. Although octreotide may be an effective therapy in refractory sulphonylurea-induced hypoglycaemia, it should be used with caution in patients on dialysis.

Somatostatin analog therapy for severe polycystic liver disease: results after 2 years

“…Dose adjustments are advised for patients with severe renal impairment. Cases of hyperkalemia (due to the drug's impact on insulin-mediated potassium transport) have been reported in patients on dialysis [20][21][22]. Therefore, the starting dose for patients on dialysis should not exceed 10 mg every 4 weeks according to the product information sheet for Sandostatin LAR (octreotide).…”

Carcinoid Tumour Management in Haemodialysis: A Case Report

“…Octreotide causing severe hyperkalaemia in a haemodialysis patient has been reported in a case study where octreotide was used for hypoglycaemia 4 . Hyperkalaemia was attributed to octreotide‐induced insulin suppression and impaired cellular potassium uptake.…”

Briefly Noted

“…Treatment of glipizide ‐induced hypoglycemia with octreotide (which inhibits insulin release) in a patient on dialysis was associated with a rise in serum potassium from 4.2 to 7.3 mmol/L (10). The hyperkalemia was attributed to the drug’s impact on insulin‐mediated potassium transport.…”