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== Definition==
== Definition==
Hyperkalemia is best defined as a serum potassium concentration greater than 5.5 mEq/L in adults; levels higher than 7 mEq/L can lead to significant hemodynamic compromise
[[Hyperkalemia]] is best defined as a serum potassium concentration greater than 5.5 mEq/L in adults; levels higher than 7 mEq/L can lead to significant hemodynamic compromise
 
==Causes==
==Causes==
===Life-Threatening Causes===
===Life-Threatening Causes===

Revision as of 04:12, 20 July 2013

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; associate editor-in-chief: Mahmoud Sakr, M.D. [2]

Definition

Hyperkalemia is best defined as a serum potassium concentration greater than 5.5 mEq/L in adults; levels higher than 7 mEq/L can lead to significant hemodynamic compromise

Causes

Life-Threatening Causes

Immediate life-threatening causes are conditions which result in immediate death or disability if left untreated.

Common Causes

Management

Please find below an algorithm that summarizes the approach to hyperkalemia

 
 
 
 
 
 
 
 
Check vital signs
Stabilize the patient
Order an EKG
Concise history and physical exam
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Assess EKG
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
EKG changes;e.g. hyperacute T waves, widened QRS,
 
 
 
 
 
 
 
 
 
 
EKG not changed, patient stable
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
use rapidly acting transient agents,e.g Insulin, Dextrose, IV calcium, inhaled Beta2 agonists
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Kayexalate, orally, and also can be given rectally in unconscious patients to avoid risks of aspiration
 
 
 
IV hydration
 
 
 
stop potential causative medications
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
use carefully in potential heart failure patients,
consider diuresis when clinically appropriate
 
 
 
consult with nephrology for resistant and severe cases of hyperkalemia
may require urgent dialysis, yet rare
 

Do's and Don'ts

  • Place the patient on a closely monitored bed
  • Repeat basic metabolic panels frequently
  • Be ware when using kayexalate, as it has been reported to cause colonic transmural necrosis[1]
  • Remove the offending medications that are associated with Hyperkalemia
  • Keep the patient well hydrated
  • Check levels of other electrolytes such as Magnesium and phosphorus as it may be abnormal as well.
  • Avoid over treating with IV Bicarbonate as it may lead to rebound metabolic alkalosis
  • Consider consultation with nephrology

References

  1. Empty citation (help)


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