Genetic Determinants of the Hypokalemic and Hyperglycemic Effect of Albuterol Inhalation

Evaluation of β2 Genetic Polymorphisms and the Effect of Albuterol Inhalation on Potassium and Glucose Plasma Concentration

Several studies have indicated that albuterol administered either intravenously or by inhalation can significantly reduce plasma potassium concentration in patients suffering from chronic renal failure.In conjunction with the decrease in potassium concentration a modest rise in glucose concentration is usually noted. These metabolic effects are characterized by rapid onset occurring as early as 3-5 minutes following salbutamol administration and lasting for at least 1 hour.

The role played by ß2AR polymorphisms in determining the bronchial and vascular response to ß2AR agonist drugs, have been confirmed by several studies.

The purpose of the present study is to examine possible causal relationships between genetically based alteration in the structure of ß2AR and the metabolic effects of inhaled albuterol.

Inclusion Criteria:

• patients regularly attending the nephrological clinic or the dialysis unit
• persistent potassium concentration above 5 mEq/L

Exclusion Criteria:

1. Patients suffering from active ischemic heart disease
2. Patient with a recent history of arrhythmia
3. Patients treated regularly with ß blockers
4. Patients treated regularly with salbutamol or other ß2AR agonists
5. Patients suffering from persistent tachycardia (pulse > 100 beats/min)
6. Patients who are hemodynamically unstable
7. Patients suffering from any acute illness