{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T15:20:56Z","timestamp":1787498456342,"version":"build-2736575974"},"reference-count":18,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T00:00:00Z","timestamp":1763424000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["accpjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacotherapy"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>\n                      Intravenous regular insulin is often used for the management of hyperkalemia due to its rapid onset of action and predictable potassium\u2010lowering effects. Various studies have been conducted to determine optimal insulin dosing strategies that reduce serum potassium levels without increasing hypoglycemia risk. As data shifts towards lower or fixed insulin doses, validating the appropriateness of these dosing regimens for the management of hyperkalemia in overweight patients is warranted. The purpose of this study was to evaluate the serum potassium\u2010lowering effects of 5\u2009units versus 10\u2009units of intravenous regular insulin in hyperkalemic patients with a body mass index (BMI) \u2265\u200925\u2009kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A multicenter, retrospective study was performed in adult patients with BMI \u2265\u200925\u2009kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      who received 5 or 10\u2009units of intravenous regular insulin for the treatment of hyperkalemia. The primary outcome was the potassium\u2010lowering effects of 5\u2009units versus 10\u2009units of intravenous regular insulin. Secondary outcomes include the incidence of hypoglycemic episodes within 6\u2009h of insulin administration, hospital length of stay (LOS), and treatment failure.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 699 patients screened, 81 patients received 5\u2009units and 81 patients received 10\u2009units. There was no difference in the serum potassium\u2010lowering effects of 5\u2009units versus 10\u2009units of intravenous regular insulin (0.5 (0.1\u20131.1) mmol\/L vs. 0.5 (0.2\u20131) mmol\/L;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.65). No significant differences were observed for any secondary outcomes. Subgroup analyses revealed no significant differences for BMI; the number of concomitant acute potassium\u2010lowering therapies received; or the degree of renal impairment, aside from a significantly larger potassium\u2010lowering effect with 10\u2009units of intravenous regular insulin observed in the subgroup receiving no concomitant acute potassium\u2010lowering therapies as well as the subgroup with a creatinine clearance of 30\u201360\u2009mL\/min.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this small, retrospective cohort study, treatment with 5\u2009units of intravenous regular insulin did not compromise the serum potassium\u2010lowering effect when compared to 10\u2009units in overweight patients with hyperkalemia. Further controlled studies are warranted to confirm these findings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/phar.70080","type":"journal-article","created":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T17:13:45Z","timestamp":1763486025000},"page":"794-800","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Intravenous Regular Insulin for Treatment of Hyperkalemia in Overweight Patients"],"prefix":"10.1002","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2838-7222","authenticated-orcid":false,"given":"Denise","family":"Kelley","sequence":"first","affiliation":[{"name":"University of Texas College of Pharmacy  Austin Texas USA"},{"name":"Department of Pharmacy Dell Seton Medical Center at the University of Texas at Austin  Austin Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2049-5672","authenticated-orcid":false,"given":"Sarah","family":"Piccuirro","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Ascension Seton Medical Center Austin  Austin Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prakruti","family":"Gandhi","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Dell Seton Medical Center at the University of Texas at Austin  Austin Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannah","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Dell Seton Medical Center at the University of Texas at Austin  Austin Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,11,18]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/phar.2038"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2015.05.040"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/phar.2596"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ekir.2017.10.009"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCE.0000000000000092"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jemermed.2019.03.043"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/jhm.977"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1177\/0897190018799220"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/jhm.2545"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.12788\/jhm.3357"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1177\/1060028015607559"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.110.971069"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1177\/0018578719841035"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0026-0495(98)90001-4"},{"key":"e_1_2_10_16_1","unstructured":"Centers for Disease Control and Prevention \u201cAdult Obesity Facts \u201daccessed June 3 2025 https:\/\/www.cdc.gov\/obesity\/adult\u2010obesity\u2010facts\/index.html."},{"key":"e_1_2_10_17_1","unstructured":"National Institute of Diabetes and Digestive and Kidney Diseases \u201cDefinition & Facts for Adult Overweight & Obesity U.S. Department of Health and Human Services National Institutes of Health 2023 \u201daccessed September 11 2025 https:\/\/www.niddk.nih.gov\/health\u2010information\/weight\u2010management\/adult\u2010overweight\u2010obesity\/definition\u2010facts."},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1080\/17425255.2018.1440287"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2125.2005.02476.x"}],"container-title":["Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/accpjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/phar.70080","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,24]],"date-time":"2025-12-24T10:14:46Z","timestamp":1766571286000},"score":1,"resource":{"primary":{"URL":"https:\/\/accpjournals.onlinelibrary.wiley.com\/doi\/10.1002\/phar.70080"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,18]]},"references-count":18,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2025,12]]}},"alternative-id":["10.1002\/phar.70080"],"URL":"https:\/\/doi.org\/10.1002\/phar.70080","archive":["Portico"],"relation":{},"ISSN":["0277-0008","1875-9114"],"issn-type":[{"value":"0277-0008","type":"print"},{"value":"1875-9114","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,18]]},"assertion":[{"value":"2025-06-18","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication 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