Hyperkalemia: how to identify – and correct – the underlying cause... second of two articles.

Hyperkalemia: how to identify – and correct – the underlying cause... second of two articles.

Rutecki G W; Whittier F C

Consultant (00107069)

1996

1996-03

Precipitants of hyperkalemia include diabetes, certain medications (eg, NSAIDs, ACE inhibitors), tissue injury, and hormonal abnormalities. Hyperkalemia alters the extracellular to intracellular potassium gradient, which decreases the resting membrane potential and may cause flaccid muscle paralysis and cardiac arrhythmias. Use the absolute serum potassium level and an ECG to measure the extent of end-organ dysfunction. ECG abnormalities include tall peaked T waves, decreased amplitude and/or absence of P waves, and QRS widening. To manage hyperkalemia, start with a membrane stabilizer (eg, IV calcium gluconate; also give agents (eg, insulin, sodium bicarbonate, or beta-agonists) that shift excess extracellular potassium into cells. To remove potassium altogether, consider diuretics, sodium polystyrene sulfonate, and/or dialysis.

Adult; Female; Dialysis; Male; Outpatients; Electrocardiography; Middle Age; Diagnosis; Differential; Laboratory; Insulin – Administration and Dosage; Adrenergic Beta-Agonists – Administration and Dosage; Calcium – Administration and Dosage; Cation Exchange Resins – Administration and Dosage; Diuretics – Administration and Dosage; Hyperkalemia – Diagnosis; Hyperkalemia – Drug Therapy; Hyperkalemia – Etiology; Potassium – Analysis; Sodium Bicarbonate – Administration and Dosage

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