Management of Hyperkalemia: An Update for the Internist.
Am J Med. 2015 Jun 17;
Authors: Kovesdy CP
Abstract
Hyperkalemia is a clinically important electrolyte abnormality which occurs most commonly in patients with chronic kidney disease. Due to its propensity to induce electrophysiological disturbances, severe hyperkalemia is considered a medical emergency. The management of acute and chronic hyperkalemia can be achieved through the implementation of various interventions, one of which is the elimination of medications that can raise serum potassium levels. Since many such medications (especially inhibitors of the renin-angiotensin aldosterone system) have proven beneficial effects in patients with cardiovascular and renal disease, their discontinuation for reasons of hyperkalemia represent an undesirable clinical compromise. The emergence of two new potassium binding medications for acute and chronic therapy off hyperkalemia may soon allow the continued use of medications such as RAAS inhibitors even in patients who are prone to hyperkalemia. This review article provides an overview of the physiology and the pathophysiology of potassium metabolism and hyperkalemia, the epidemiology of hyperkalemia, and its acute and chronic management. We discuss in detail emerging data about new potassium-lowering therapies, and their potential future role in clinical practice.
PMID: 26093176 [PubMed - as supplied by publisher]