Serum K+ >5.5 mmol/L.
Causes
- • Reduced excretion (AKI/CKD, ACEi/ARB/MRA, NSAIDs)
- • Increased release (rhabdo, tumour lysis, haemolysis)
- • Redistribution (acidosis, insulin deficiency)
Clinical features
- • Weakness, paraesthesia, palpitations
- • Often asymptomatic
Investigations
- • Serum K+ (repeat, exclude haemolysis)
- • ECG (tall T, wide QRS, sine wave)
- • U&E, glucose, ABG
Management
- • Cardiac protection: calcium gluconate 10% 30 mL IV over 5 min (chloride if central)
- • Shift: insulin 10 U + 50 mL 50% dextrose IV, salbutamol nebs 10-20 mg
- • Removal: patiromer/lokelma PO, loop diuretic, urgent haemodialysis
Complications
- • Cardiac arrest (VF/asystole)
References
- • Renal Association 2020
Related in WardRound
Educational — verify locally.
