Hyperkalemia, Questions

1.    What are the EKG manifestations associated with hyperkalemia?  Do these changes occur in a particular order?

2.    What is the role of Kayexalate in the treatment of hyperkalemia?

3.    Is there a threshold serum potassium level or particular EKG finding that triggers you to administer calcium?  How do you give calcium when you use it?

4.    When do you re-dose patients you’ve treated for hyperkalemia?

Hyperkalemia Questions Poster

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2 Responses to Hyperkalemia, Questions

  1. James Mitchiner says:

    Some of my colleagues routinely give IV CaGluconate for significant hyperkalemia, even in the absence of arrhythmias. Is this necessary or wise?

    • emlyceum says:

      Dr. Mitchiner: thank you for your question and your reading of the site. The question of when to give calcium (gluconate or chloride) is #3 on our hyperkalemia questions for this month, the “answers” to which are to be published shortly. In brief, there doesn’t appear to a set guideline or evidence basis for giving calcium based on severity of hyperkalemia, although consensus and “expert” recommendation typically includes severity as a reason to give it. This appears to be even in the absence of EKG changes, for the sake of stabilizing cardiac myocytes that have not yet evidenced a clinical change but may do so soon.

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