Life-threatening hyperkalemia in a patient with normal renal function

Ayach, Taha; Nappo, Robert W.; Paugh‐Miller, Jennifer L.; Ross, Edward A.

doi:10.1093/ckj/sft151

Cited by 8 publications

(7 citation statements)

References 15 publications

(18 reference statements)

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“…The ECG findings in hyperkalemia include tall T waves, prolonged PR interval, shortening of QT interval, and reduction in amplitude of P waves. Ventricular rhythms (sine waves) with wide complex QRS complexes, ventricular fibrillation and asystole might be seen in untreated or severe hyperkalemia cases [4]. …”

Section: Discussionmentioning

confidence: 99%

Hyperkalemia from Dietary Supplements

Batra

Villgran

2016

Cureus

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Hyperkalemia is a common electrolyte problem in patients with chronic kidney disease. It is typically caused by medications in patients with poor kidney function. Patients with comorbodities such as heart failure and diabetes are predisposed to electrolyte problems. Salt substitutes and dietary supplements are uncommon causes of hyperkalemia, but we propose that they are under-recognized and underdiagnosed causes in patients with chronic kidney disease. Our case report and literature review illustrates that a careful dietary history is essential in patients presenting with electrolyte disorders, especially hyperkalemia.

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Section: Discussionmentioning

confidence: 99%

Hyperkalemia from Dietary Supplements

Batra

Villgran

2016

Cureus

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“…4 Other less common causes of serum hyperkalaemia have been reported and include the use of medications known to interfere with the renal clearance of potassium (such as potassium-sparing diuretics) and patients with excessive potassium intake. 5 , 6 The above causes of hyperkalaemia can be thought of as ‘true hyperkalaemia’, as the serum potassium reflects the in vivo picture.…”

Section: Introductionmentioning

confidence: 99%

The potential role of the eGFR in differentiating between true and pseudohyperkalaemia

et al. 2020

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Background: Differentiating between true and pseudohyperkalaemia is essential for patient management. Common causes of pseudohyperkalaemia include haemolysis, blood cell dyscrasias and EDTA contamination . One approach to differentiate between them is by checking the renal function, as it is believed that true hyperkalaemia is rare with normal function. This is logical, but there is limited published evidence to support it. The aim of this study was to investigate the potential role of the eGFR in differentiating true from pseudohyperkalaemia. Methods: GP serum potassium results >6.0 mmol/L from 01/01/2017-31/12/2017, with a repeat within 7 days, were included. Entries were retrospectively classified as true or pseudohyperkalaemia based on the potassium reference change value and reference interval. If the initial sample had a FBC, it was classified as normal/abnormal to remove blood cell dyscrasias. Different eGFR cut-points were used to determine the potential in differentiating true from pseudohyperkalaemia. Results: 272 patients were included with potassium results >6.0 mmol/L, with 145 classified as pseudohyperkalaemia. At an eGFR of 90 ml/min/1.73 m2, the negative predictive value (NPV) was 81% (95% CI: 67-90%), this increased to 86% (95% CI: 66-95%) by removing patients with abnormal FBC. When only patients with an initial potassium â¥6.5 mmol/L were included (regardless of FBC), at an eGFR of >90 ml/min/1.73 m2, the NPV was 100%. Lower NPVs were seen with decreasing eGFR cut-points. Conclusion: Normal renal function was not associated with true hyperkalaemia, making the eGFR a useful tool in predicting true from pseudohyperkalaemia, especially for potassium results â¥6.5 mmol/L

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“…Warnings have been issued about dual or triple inhibition of the RAAS 7,9,10,39,41 and an overuse of potassium-rich dietary supplements. 42…”

Section: Discussionmentioning

confidence: 99%

“…Even more attention should be paid to patient groups which are known to be likely to develop electrolyte disbalances and to have polypharmaceutic permanent medication, such as elderly people. Warnings have been issued about dual or triple inhibition of the RAAS 7,9,10,39,41 and an overuse of potassium‐rich dietary supplements 42 …”

Section: Discussionmentioning

confidence: 99%