BACKGROUND Few studies have evaluated the prevalence of severe hyperkalaemia in unselected patient populations. We identified all episodes of severe hyperkalaemia occurring in 1 year, and described patient demographics, clinical response and outcome. We also assessed junior doctor knowledge of its causes and significance. MATERIALS AND METHODS A retrospective interrogation of the database of ...

BACKGROUND Recent studies have shown a fall in global mortality with minimal side effects in severe congestive heart failure (CHF) patients receiving angiotensin-converting enzyme inhibitors (ACEI) plus spironolactone (SLN). However, the risk of hyperkalaemia due to ACEI may be increased by the concomitant use of SLN. METHODS We conducted a retrospective cohort study by examining consecutive ...

The use of suxamethonium (succinylcholine) for rapid-sequence intubation may be limited by hyperkalaemia. Modest pre-induction hyperkalaemia is usually disregarded. We present a patient who underwent emergency surgery for a perforated peptic ulcer after being bedbound for 26 days because of a head injury. Serum potassium level was 4.0 mmol/L. The patient was intubated after injection of sedativ...

Barbiturate coma therapy (BCT) is a treatment option that is used for refractory intracranial hypertension after all other options have been exhausted. Although BCT is a brain protection treatment, it also has several side effects such as hypotension, hepatic dysfunction, renal dysfunction, respiratory complications and electrolyte imbalances. One less concerning but potentially life-threatenin...

Co-trimoxazole is a combination antibiotic made up of trimethoprim and sulphamethoxazole that is first line treatment for Pneumocystis jirovecii pneumonia (PJP). Hyperkalaemia is a relatively common side effect of the trimethoprim component of co-trimoxazole but it is not well recognised by clinicians. The mechanism of action causing hyperkalaemia due to trimethoprim is similar to the potassium...

Hyperkalaemia is associated with diabetes, but there are no recent reports of its prevalence and associations. Serum potassium concentrations were measured in all 1764 patients attending a diabetic clinic over a 12-month period and found to be > 5.0 mmol/l in 270 (15%), and > 5.4 mmol/l in 67 (4%). There was no other evident cause of hyperkalaemia in 41 of these 67 patients. These data serve to...

OBJECTIVE To determine the safety of spironolactone prescribing in the setting of the UK National Health Service. DESIGN Population based longitudinal analysis using a record linkage database. SETTING Tayside, Scotland. Population All patients who received one or more dispensed prescriptions for spironolactone between 1994 and 2007. MAIN OUTCOME MEASURES Rates of prescribing for spironola...

OBJECTIVES To characterise the risk of admission to hospital for hyperkalaemia in elderly patients treated with trimethoprim-sulfamethoxazole in combination with spironolactone. DESIGN Population based nested case-control study. SETTING Ontario, Canada, from 1 April 1992 to 1 March 2010. PARTICIPANTS Cases were residents of Ontario aged 66 years or above receiving chronic treatment with s...

Objectives To characterise the risk of admission to hospital for hyperkalaemia in elderly patients treated with trimethoprim-sulfamethoxazole in combination with spironolactone. Design Population based nested case-control study. Setting Ontario, Canada, from 1 April 1992 to 1 March 2010. Participants Cases were residents of Ontario aged 66 years or above receiving chronic treatment with spirono...