Date of publication: May 19, 2016

Medical Education

Hyperkalemia Disease State

Hyperkalemia is a common co-morbidity in patients with chronic kidney disease (CKD), heart failure, diabetes or those on concomitant medication, especially renin-angiotensin aldosterone system inhibitors used to treat hypertension.[1] The frequency of hyperkalemia increases linearly with the stage of CKD, while increasing severity of hyperkalemia is associated with higher mortality.[2] Although mild cases are asymptomatic, severe hyperkalemia manifests itself as potentially life-threatening cardiac arrhythmias that require prompt treatment.[3] Understanding the pathophysiology of hyperkalemia, especially how serum potassium levels can be affected by concomitant medication, is critical in recognising the best management options available for hyperkalemia in CKD.

This presentation provides you with a brief overview of the physiology and pathophysiology of hyperkalemia, including the mechanisms that maintain serum potassium in the body,[4,5] how hyperkalemia is defined,[2] its relationship with CKD,2 and the risk factors, symptoms and diagnosis of the condition.[3] The presentation also introduces you to the available options currently used in the acute and long-term management of hyperkalemia, the benefits and limitations of each therapy, and some of the challenges, such as adherence and confounding effects of concomitant medication.

References

  1. Kovesdy CP. Management of hyperkalaemia in chronic kidney disease. Nat Rev Nephrol 2014;10:653–662.
  2. Einhorn LM, Zhan M, Hsu VD, et al. The frequency of hyperkalemia and its significance in chronic kidney disease. Arch Intern Med 2009;169:1156–1162.
  3. Kraft MD, Btaiche IF, Sacks GS, et al. Treatment of electrolyte disorders in adult patients in the intensive care unit. Am J Health Syst Pharm 2005;62:1663–1682.
  4. Giebisch G. Renal potassium transport: mechanisms and regulation. Am J Physiol 1998;274:F817–833.
  5. Weisberg LS. Management of severe hyperkalemia. Crit Care Med 2008;36:3246–3251.

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