Hyperkalemia resident survival guide: Difference between revisions
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Revision as of 22:11, 19 July 2013
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.
- Acute Renal Failure
- Rhabdomyolysis
- Rapid tissue necrosis
- Tumor Lysis syndrome
- Metabolic acidosis, diabetic ketoacidosis
- Massive hemolysis
- large IV doses of Calcium chloride or calcium gluconate
- Adrenal insufficiency
Common Causes
- Pseudoyperkalemia
- Renal insufficiency
- Adrenal insufficiency
- Medications; ACE inhibitors, Angiotensin receptor blockers, amiloride,spironolactone, NSAIDS, ciclosporin, Tacrolimus, Trimethoprim, Pentamidine
- Renal tubular acidosis
- Iatrogenic
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 | ||||||||||||||||||||||||||||||||||||||||||||||||||
order Kayexalate | |||||||||||||||||||||||||||||||||||||||||||||||||||
F01 | F02 | F03 | |||||||||||||||||||||||||||||||||||||||||||||||||
H011 H012 H013 | H021 H022 | ||||||||||||||||||||||||||||||||||||||||||||||||||