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. Hyperkalemia, a life-threatening condition caused by extracellular potassium shift or decreased renal potassium excretion, usually presents with non-specific symptoms. Early recognition of moderate to sev...

To identify factors associated with the development of hyperkalemia in patients with chronic kidney disease (CKD), we analyzed conditions present during episodes of hyperkalemia in two patients with insulin-dependent diabetes mellitus who had elevated serum potassium concentration ([K]) in ≥ 20% of the blood samples during both the pre-hemodialysis and the hemodialysis period. In both patients,...

The form of renal tubular acidosis associated with hyperkalemia is usually attributable to real or apparent hypoaldosteronism. It is therefore a common feature in diabetes and a number of other conditions associated with underproduction of renin or aldosterone. In addition, the close relationship between potassium levels and ammonia production dictates that hyperkalemia per se can lead to acido...

BACKGROUND Compared with serum potassium levels 4-5.5 mEq/L, those <4 mEq/L have been shown to increase mortality in chronic heart failure (HF). Expert opinions suggest that serum potassium levels >5.5 mEq/L may be harmful in HF. However, little is known about the safety of serum potassium 5-5.5 mEq/L. METHODS Of the 7788 chronic HF patients in the Digitalis Investigation Group trial, 5656 ha...

BACKGROUND Drospirenone/ethinyl-estradiol is an oral contraceptive (OC) that possesses unique antimineralocorticoid activity. It is conjectured that drospirenone, taken alone or concomitantly with spironolactone, may be associated with an increased risk of hyperkalemia. METHODS A retrospective cohort study was conducted evaluating women between 18-46 years of age in the Lifelink™ Health Plan ...

Little is known about the frequency and patterns of hyperkalemia in clinical settings. We evaluated the association between baseline antihypertensive medications that may affect potassium levels (angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, β-blockers, loop/thiazide diuretics, and potassium-sparing diuretics) and hyperkalemia, defined by potassium >5 mEq/L and >5.5 m...

OBJECTIVE Disturbances in potassium (K) levels are relatively common and may be associated with significant morbidity and mortality; however, treatments vary. Our purpose was to determine the incidence, treatments, and outcomes associated with hyperkalemia and hypokalemia in emergency department (ED) patients. METHODS We performed a structured, retrospective review of electronic medical recor...

BACKGROUND Concerns about hyperkalemia limit the use of angiotensin-converting enzyme inhibitors (ACE-I) and angiotensin receptor blockers (ARBs), but guidelines conflict regarding potassium-monitoring protocols. We quantified hyperkalemia monitoring and risks after ACE-I/ARB initiation and developed and validated a hyperkalemia susceptibility score. METHODS AND RESULTS We evaluated 69 426 ne...

∑ Hyperkalemia develops when the regulation between potassium intake and potassium excretion, or the distribution between intraand extracellular potassium is disturbed. It is a common, silent, and potentially lethal clinical condition, which seldom occurs in patients with normal renal function. Clinically, the most important effect of hyperkalemia is that which the condition has on the myocardi...