Treatment of life-threatening hyperkalemia with peritoneal dialysis in the ED

Roseman, David L.; Schechter‐Perkins, Elissa M.; Bhatia, Jasvinder S.

doi:10.1016/j.ajem.2014.08.041

Cited by 10 publications

(4 citation statements)

References 14 publications

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“…Taken altogether, these data suggest using a potassium dialysate concentration ≥ 2.0 mmol/L to avoid a too rapid drop in serum potassium using dialysis. Treatment of hyperkalemia using peritoneal dialysis has been described anecdotally and appears feasible when alternatives are not readily available [85]. Alternatives to prevent rapid and profound drop of serum potassium is to use low flow techniques (i.e., continuous hemofiltration, continuous hemodialysis or slow low efficiency or extended dialysis) (Fig.…”

Section: Medical Strategymentioning

confidence: 99%

Management of hyperkalemia in the acutely ill patient

Dépret

Peacock

Liu

et al. 2019

Ann. Intensive Care

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Purpose To review the mechanisms of action, expected efficacy and side effects of strategies to control hyperkalemia in acutely ill patients. Methods We searched MEDLINE and EMBASE for relevant papers published in English between Jan 1, 1938, and July 1, 2018, in accordance with the PRISMA Statement using the following terms: “hyperkalemia,” “intensive care,” “acute kidney injury,” “acute kidney failure,” “hyperkalemia treatment,” “renal replacement therapy,” “dialysis,” “sodium bicarbonate,” “emergency,” “acute.” Reports from within the past 10 years were selected preferentially, together with highly relevant older publications. Results Hyperkalemia is a potentially life-threatening electrolyte abnormality and may cause cardiac electrophysiological disturbances in the acutely ill patient. Frequently used therapies for hyperkalemia may, however, also be associated with morbidity. Therapeutics may include the simultaneous administration of insulin and glucose (associated with frequent dysglycemic complications), β-2 agonists (associated with potential cardiac ischemia and arrhythmias), hypertonic sodium bicarbonate infusion in the acidotic patient (representing a large hypertonic sodium load) and renal replacement therapy (effective but invasive). Potassium-lowering drugs can cause rapid decrease in serum potassium level leading to cardiac hyperexcitability and rhythm disorders. Conclusions Treatment of hyperkalemia should not only focus on the ability of specific therapies to lower serum potassium level but also on their potential side effects. Tailoring treatment to the patient condition and situation may limit the risks. Electronic supplementary material The online version of this article (10.1186/s13613-019-0509-8) contains supplementary material, which is available to authorized users.

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Section: Medical Strategymentioning

confidence: 99%

Management of hyperkalemia in the acutely ill patient

Dépret

Peacock

Liu

et al. 2019

Ann. Intensive Care

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“…The normalization of serum K + is the priority because hyperkalemia is an important risk factor of life-threatening conditions, such as cardiac arrest. Recently, Roseman et al demonstrated the potential utility of peritoneal dialysis as a treatment option for severe hyperkalemia patients when HD access is limited [18]. In the present study, we calculated the removal rate of serum K + by MFR and PPD.…”

Section: Discussionmentioning

confidence: 96%

Fluid resuscitation with preventive peritoneal dialysis attenuates crush injury-related acute kidney injury and improves survival outcome

Zhou

Xiong

et al. 2019

Scand J Trauma Resusc Emerg Med

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Background In-hospital renal replacement therapy (RRT) is widely used for the treatments of acute kidney injury (AKI) in crush injury (CI) victims. This study was designed to investigate whether preventive peritoneal dialysis (PPD) is useful for renal protection in CI. Methods Animals received hindlimb compressions for 6 h to induce CI. Then, animals were untreated or treated with PPD and/or massive fluid resuscitation (MFR) for 8 h since the onset of compression release. Blood and renal tissue samples were collected at various time points for biological and morphological analysis. Results PPD attenuated lactic acidosis and reduced serum K + and myoglobin levels in CI animals. In addition, PPD was effective in removing blood urea nitrogen (BUN) and creatinine, and reduced renal expressions of neutrophil gelatinase-associated lipocalin (NGAL). The combination of PPD and MFR furtherly attenuated AKI with significantly decreased histological scores ( p = 0.037) and reduced NGAL expressions ( p = 0.0002) as compared with the MFR group. Moreover, MFR + PPD group had a significantly higher survival rate than that in the MFR and the PPD groups ( p < 0.05, respectively). Conclusion The use of PPD at the onset of compression release is beneficial for renal protection and survival outcome in a rabbit model of CI. Electronic supplementary material The online version of this article (10.1186/s13049-019-0644-0) contains supplementary material, which is available to authorized users.

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“…Successful treatment of life-threatening hyperkalaemia with frequent manual PD exchanges and automated PD with 24 h cycler has been reported. 48,49 We consider PD a feasible way to manage life-threatening hyperkalaemia, especially in facilities that do not have access to HD. In addition to dialysis, of course, other therapies should be started to reduce the serum potassium.…”

Section: Can We Use Pd To Manage Life-threatening Hyperkalaemia In Ho...mentioning

confidence: 99%

Care of the hospitalised patient receiving peritoneal dialysis: Your questions answered

Albakr

Bargman

2022

Perit Dial Int

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Peritoneal dialysis (PD) patients have higher hospitalisation rates than the general population. The hospitalisations are not always related to dialysis issues, and physicians with little or no experience with PD may be responsible for the care of these hospitalised patients. Furthermore, the hospital may not be familiar with or equipped to manage these patients. This review highlights barriers, knowledge gaps and management strategies to guide the care of hospitalised PD patients.

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Treatment of life-threatening hyperkalemia with peritoneal dialysis in the ED

Cited by 10 publications

References 14 publications

Management of hyperkalemia in the acutely ill patient

Management of hyperkalemia in the acutely ill patient

Fluid resuscitation with preventive peritoneal dialysis attenuates crush injury-related acute kidney injury and improves survival outcome

Care of the hospitalised patient receiving peritoneal dialysis: Your questions answered

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