Management of severe hyperkalemia

  title={Management of severe hyperkalemia},
  author={Lawrence S. Weisberg},
  journal={Critical Care Medicine},
  • L. Weisberg
  • Published 1 December 2008
  • Medicine
  • Critical Care Medicine
Background and Objectives:Hyperkalemia is one of the few potentially lethal electrolyte disturbances. Prompt recognition and expeditious treatment of severe hyperkalemia are expected to save lives. This review is intended to provide intensivists and other interested clinicians with an understanding of the pathophysiology that underlies hyperkalemia, and a rational approach to its management. Methods:This article reviews and analyzes literature relevant to the pathophysiology and management of… 


A narrative review over the literature using electronic databases as; MEDLINE, and EMBASE for studies involving data on Hyperkalemia management in emergency department, published in English language up to 2018 shows the importance of management and different approaches in ED.

Advances in diagnosis and management of hypokalemic and hyperkalemic emergencies.

The etiology, differential diagnosis, and diagnostic studies for detecting hypokalemia and hyperkalemia, including managing laboratory errors that lead to factitious potassium findings are discussed, with recommendations on criteria for disposition.

The emergency physician and the prompt management of severe hyperkalemia

A case is reported that gives an opportunity to discuss the importance of a faster approach to hyperkalemia, a potentially lethal electrolyte disturbance because of threatening dysrhythmias that can occur at any moment.

Management of Hyperkalemia: An Update for the Internist.

  • C. Kovesdy
  • Medicine, Biology
    The American journal of medicine
  • 2015

A physiologic-based approach to the treatment of acute hyperkalemia.

  • R. ShingarevM. Allon
  • Medicine
    American journal of kidney diseases : the official journal of the National Kidney Foundation
  • 2010
The present case highlights key physiologic mechanisms in the development of hyperkalemia and provides an outline for emergent treatment, and discusses specific mechanisms of action of available treatments of hyperKalemia.

Treatment and pathogenesis of acute hyperkalemia

This article focuses on the pathogenesis, clinical manifestations, and various treatment modalities for acute hyperkalemia and presents a systematic approach to selecting a treatment strategy.

Controversies in Management of Hyperkalemia.

Hyperkalemia management in the emergency department: An expert panel consensus

Information on available therapies for hyperkalemia is summarized and a hyperKalemia treatment algorithm for the ED practitioner is proposed based on the currently available literature and highlights diagnostic pitfalls and evidence gaps.

Incidental Hyperkalemia: An Unusual and Unexpected Case of Severe Hyperkalemia in an Otherwise Stable Post-Liver Transplant Recipient

A 68-year-old man in stable condition was found to have a serum potassium level of 7.9 mmol/L one year after an orthotopic liver transplant, and his hyperkalemia resolved with conventional therapy and adjustment of his medications.



Hyperkalemia in Dialysis Patients

This article reviews extrarenal potassium homeostasis and its alteration in patients with end‐stage renal disease and pays particular attention to the factors that influence the movement of potassium across cell membranes.

Hyperkalemia: a potential silent killer.

Clinical management requires exclusion of pseudohyperkalemia, assessment of the urgency for treatment, and institution of appropriate therapy, and long-term treatment requires identification of the etiology and prevention of recurrence.

Studies to determine the basis for hyperkalemia in recipients of a renal transplant who are treated with cyclosporine.

The renal response to hyperkalemia was inappropriate because the transtubular K+ concentration gradient (TTKG) was only 4.3 +/- 0.4, which led to the suspicion of the possibility that their basis might be type II hypoaldosteronism.

Role of hyperkalemia in the metabolic acidosis of isolated hypoaldosteronism.

Correcting the hyperkalemia by potassium-sodium exchange resin alone resolved the acidosis and restored the previously diminished urinary ammonium excretion to normal, apparently interferes with urinary acidification.

Hyperkalemia in hospitalized patients

An elevated serum potassium level in ahospitalized patient may be a marker for asignificantly increased risk of death, which is due tounderlying medical problems and is not a consequence of the hyperkalemia.

Digitalis intoxication; a review and report of forty cases, with emphasis on etiology.

The premise of this paper is to be sure that the patient has just enough digitalis, that he is neither underdigitalized nor toxic, and the need for careful follow-up of patients who are being digitalized.

Management of hyperkalemia with a cation-exchange resin.

The use of a sulfonic polystyrene cation-exchange resin in the sodium cycle∥ for the control of hyperpotassemia in both acute and chronic renal disease is described.

Hyperkalaemia in patients in hospital.

A survey of all laboratory blood specimens with a plasma potassium concentration greater than or equal to 5.5 mmol/L was conducted over a three month period, finding that hyperkalaemia must always be considered seriously and regard given to the overall clinical status of the patient.