SHM Converge Scientific Abstract ePoster Gallery-"ORANGE" YOU GLAD FOR CRANBERRY JUICE?<br /><br />improving MANAGEMENT OF HYPOGLYCEMIA IN PATIENTS WITH CHRONIC KIDNEY DISEASE OR END-STAGE RENAL DISEASE

"ORANGE" YOU GLAD FOR CRANBERRY JUICE?

improving MANAGEMENT OF HYPOGLYCEMIA IN PATIENTS WITH CHRONIC KIDNEY DISEASE OR END-STAGE RENAL DISEASE

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This quality-improvement project examined whether the hospital’s hypoglycemia protocol, which allows orange juice, could contribute to hyperkalemia in patients with chronic kidney disease (CKD) or end-stage renal disease (ESRD) who are on a renal diet. Because the hypoglycemia protocol and renal diet could both be active at the same time, nurses could administer orange juice even though it is excluded from the renal diet. The team noted that 118 mL of orange juice contains more potassium than apple or cranberry juice.<br /><br />The study reviewed hospitalized adults from January to June 2023 with CKD or ESRD on a renal diet. Hypoglycemia was defined as blood glucose under 70 mg/dL, and hyperkalemia as potassium 5.3 mmol/L or higher. Researchers used ICD codes and diet orders to identify patients, then manually reviewed records for hypoglycemic episodes followed by hyperkalemia.<br /><br />Among 401 eligible patients, there were 17 hypoglycemic episodes followed by hyperkalemia, representing 4.24% of the cohort. Based on these findings, the authors proposed three options: restrict patients on a renal diet to cranberry or apple juice, remove orange juice from the protocol entirely, or replace juice with glucose gel. The Inpatient/Critical Care Committee chose to revise the protocol by eliminating orange juice and making cranberry juice the first-line option.<br /><br />The authors concluded that juices used for hypoglycemia treatment may worsen hyperkalemia in CKD/ESRD patients. While other factors can also cause elevated potassium, removing orange juice may reduce one avoidable contributor.

Asset Subtitle

Sosi Dzhugarian

Meta Tag

Author List Ali-Pardis Dana, Amanda Frugoli, Esther Kuan, James T. Daly, Shivani Desai, Sosi Dzhugarian

Category Research

Concept Hypoglycemia Treatment Protocol

Concept Hyperkalemia

Concept Chronic Kidney Disease

Concept End-stage Kidney Disease

Concept Renal Diet

Distinguished Non-Finalist

Presenter Organization Community Memorial Healthcare

Presenting Author Sosi Dzhugarian

Track Quality Improvement

Keywords

hypoglycemia protocol

orange juice

hyperkalemia

chronic kidney disease

end-stage renal disease

renal diet

inpatient quality improvement

potassium

cranberry juice

glucose gel

Hypoglycemia Treatment Protocol

Hyperkalemia

Chronic Kidney Disease

End-stage Kidney Disease

Renal Diet