Hyperkalemia: Prevalence, Predictors and Emerging Treatments

Abstract

It is well established that an elevated potassium level (hyperkalemia) is associated with a risk of adverse events including morbidity, mortality and healthcare system cost. Hyperkalemia is commonly encountered in many chronic conditions including kidney disease, diabetes and heart failure. Furthermore, hyperkalemia may result from the use of renin-angiotensin-aldosterone system inhibitors (RAASi), which are disease-modifying treatments for these conditions. Therefore, balancing the benefits of optimizing treatment with RAASi while mitigating hyperkalemia is crucial to ensure patients are optimally treated. In this review, we will briefly discuss the definition, causes, epidemiology and consequences of hyperkalemia. The majority of the review will be focused on management of hyperkalemia in the acute and chronic setting, emphasizing contemporary approaches and evolving data on the relevance of dietary restriction and the use of novel potassium binders.

Management of hyperkalemia in children

“…Mild hyperkalemia is usually asymptomatic, but as the serum potassium level increases, it can cause palpitations, nausea, vomiting, diarrhea, muscle cramps, generalized weakness, paresthesia, flaccid paralysis, and life-threatening cardiac arrhythmias. A rapid increase in serum potassium can cause signs and symptoms at a lower potassium concentration than with chronic hyperkalemia [3,4]. The cardiac membrane depolarization starts with tall and peaked T-waves and shortening of the QT interval on the electrocardiogram (EKG).…”