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Case Reports
. 2021 Feb 25;11(1):69-77.
doi: 10.1159/000512590. eCollection 2021 Jan-Apr.

Surprising Hyperkalemia of 10.2 mmol/L in a Patient with Hyperglycemia: A Case Report

Jan Czogalla  1 , Pischtaz Adel Tariparast  2 , Tobias B Huber  1 , Matthias Janneck  1 , Florian Grahammer  1
Affiliations
Case Reports

Surprising Hyperkalemia of 10.2 mmol/L in a Patient with Hyperglycemia: A Case Report

Jan Czogalla et al. Case Rep Nephrol Dial. .

Abstract

Hyperkalemia is a life-threatening condition potentially leading to cardiac arrest. Here, we report a case of surprising severe hyperkalemia of 10.2 mmol/L in a diabetic patient with previously normal kidney function presenting without discernible clinical symptoms to our emergency department. The patient was admitted because of hyperglycemia of 32.8 mmol/L, which was detected during daily testing in her nursing home. The hyperkalemia was caused by prerenal failure due to hyperglycemic polyuria which led to volume depletion, and worsened by a combination of potassium-sparing drugs and potassium supplementation. The patient was treated conservatively. Eighteen hours later, the serum potassium concentration was 4.6 mmol/L. The patient could be released 6 days later. To our knowledge, this is the highest described hyperkalemia treated conservatively and survived without cardiopulmonary resuscitation.

Keywords: Diabetes mellitus; Hyperglycemia; Hyperkalemia.

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Conflict of interest statement

The authors report no competing interests.

Figures

Fig. 1
Fig. 1
Timeline according to CARE criteria. aHTN, arterial hypertension; DMII, diabetes mellitus type 2; MRGN, multiresistant gram-negative; BGA, blood gas analysis.
Fig. 2
Fig. 2
a ECG of the patient on admission, showing a broadened QRS complex and elevated T waves. b ECG of the patient after i.v. calcium gluconate, showing a sinus rhythm.
Fig. 3
Fig. 3
Evolution of hyperkalemia over time and medication administered.
See this image and copyright information in PMC

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