TITLE:
Treatment of Moderate to Severe Hypokalemia in Patients Undergoing Peritoneal Dialysis by Intraperitoneal Administration of a Hyperkalemic Dialysate
AUTHORS:
Konstantinos S. Mavromatidis, Anastasia K. Georgoulidou, Gioulia V. Romanidou, Bülent N. Kiamiloglou, Irini M. Kalogiannidou, Athanasios V. Bakaloudis
KEYWORDS:
Hypokalemia, Peritoneal Dialysis, Intraperitoneal Potassium Administration, Beta-Blockers, Heparin, Insulin, Icodextrin, Eplerenone, ACE Inhibitors
JOURNAL NAME:
Journal of Biosciences and Medicines,
Vol.13 No.12,
December
15,
2025
ABSTRACT: Background: Hypokalemia is very common in peritoneal dialysis patients. The aim of this study was to investigate the effect of a peritoneal dialysate with a high concentration of potassium in the treatment of this electrolyte disorder. Patients & Methods: For two years, among 62 patients with end-stage renal disease under peritoneal dialysis in our unit, 10 cases of moderate (serum potassium ≥ 2.3 mmol/L to ≤2.9 mmol/L) to severe hypokalemia (serum potassium β-blocker, heparin (2/10), non-steroidal anti-inflammatory drugs (3/10), and eplerenone (3/10). They all had severe hypoalbuminemia. Peritoneal dialysis fluid of 2 L/bag, with 20 mmol/L potassium, was administered every 6 hours according to the protocol, i.e., until blood potassium levels detected immediately before the next exchange bags were higher than 4 mmol/L. Results: The mean ± SD serum potassium of our patients at the beginning of the diagnosis of hypokalemia was 2.51 ± 0.39 mmol/L (5 patients with moderate and 5 with severe). It took 3 - 6 exchange bags to achieve the target blood potassium (>4 mmol/L). Generally, we gave a total of 120 - 240 mmol of potassium in the dialysate (from 3 bags of 2 L with 20 mmol/L potassium, to 6 bags of the same solution). Only 2 patients complained of pain during the filling of the abdomen (the first in one exchange and the second in all exchange bags). Conclusion: It is concluded that intra-peritoneal administration as a dialysis fluid with a content of 20 mmol/L potassium is effective, safe, and well tolerated for the restoration of blood potassium levels in patients with hypokalemia undergoing peritoneal dialysis.