Hyperkalemia

  • Common in ESRD (around 10% of HD patients)
  • Contributes to 3-5% of deaths1

Etiology

  • Excessive dietary potassium intake
  • Metabolic acidosis
  • Acute infection with marked catabolism
  • Rhabdomyolysis
  • Mineralocorticoid deficiency
  • Medications
  • Dialysis induced hyperkalemia (rare)
    • High dialysate potassium concentration2
    • Hemolysis
    • Accidental potassium infusions3                                                                                                                                                                                                  

References:

  1. Ahmed J, Weisberg LS. Hyperkalemia in dialysis patients. Semin Dial 14:348-356, 2001
  2. Brady HR, Goldberg H, Lunski C, Uldall PR. Dialysis-induced hyperkalemia presenting as profound muscle weakness. Intern J Artfi Organs 11:43-44, 1988
  3. Romagnoni M, Beccari M, Sorgato G. Life-threatening hyperkalemia during a haemodialysis session: an avoidable risk. Nephrol Dial Transplant  13:2480-2481, 1998