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Case Reports
. 2010 Sep;56(3):578-84.
doi: 10.1053/j.ajkd.2010.03.014. Epub 2010 Jun 8.

A physiologic-based approach to the treatment of acute hyperkalemia

Roman Shingarev  1 , Michael Allon
Affiliations
Case Reports

A physiologic-based approach to the treatment of acute hyperkalemia

Roman Shingarev et al. Am J Kidney Dis. 2010 Sep.

Abstract

Hyperkalemia is a common and potentially lethal disorder. Given its variable presentation, clinicians should have a high index of suspicion, especially in patients with chronic kidney disease. The present case highlights key physiologic mechanisms in the development of hyperkalemia and provides an outline for emergent treatment. In this context, we discuss specific mechanisms of action of available treatments of hyperkalemia.

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Figures

Figure 1
Figure 1
(A) Pretreatment electrocardiogram with peaked T-waves, prolonged PR and QRS intervals. (B) Posttreatment electrocardiogram with normalization of T-waves, PR and QRS intervals.
Figure 2
Figure 2
Algorithm for treatment of acute hyperkalemia. Pseudohyperkalemia should be considered in cases of hemolysis and in patients with severe thrombocytosis or leukocytosis, and proven by demonstrating that plasma potassium is lower than serum potassium. Bicarbonate is only indicated in patients with severe academia. Diuretics should be considered in patients with residual kidney function. Abbreviations: ECG, electrocardiographic; IV, intravenous; K+, potassium.
See this image and copyright information in PMC

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