Journal Mobile

CG Isles, G McKellar, A Alfonzo
Journal Issue: 
Volume 36: Issue 1: 2006




Hyperkalaemia  is  an  ever  present  threat  in  dialysis  units  and  is encountered frequently on general wards, particularly in patients with renal failure. It is important because it can cause life threatening cardiac dysrhythmia, with death by  asystole  or  ventricular  fibrillation  commonly  the  first  clinical  manifestation.Preferred therapy varies, reflecting the lack of clear evidence for an optimal regimen, but  broadly  speaking  the  choice  of  treatment  is  based  upon  the  serum  potassium level, the ECG and the likelihood that potassium will rise further.  In this review we highlight the causes, sequelae and evidence for the treatment of hyperkalaemia. Our starting point is a serum potassium of 6 mmol/l.  Thereafter, we suggest it may be useful to distinguish two groups of patients on the basis of their ECG: those whose ECG  is  normal, whom  we  consider  to  have  severe  hyperkalaemia, and  those  with ECG evidence of raised serum potassium or life threatening hyperkalaemia.