Hyperkalemia in chronic kidney disease

Kidney cartoon 4


In chronic kidney disease, excretion of potassium (K+) in the urine is impaired. Levels may also rise with ACE inhibitors and ARBs used to treat hypertension or with use of spironolactone. Levels consistently above 6.0 mmol/l are concern and should be managed. Hyperkalemia, especially levels > 6.5 mmol/l, predisposes to cardiac arrythmias.


  • Low K+ diet
  • Correct metabolic acidosis (target serum HCO3 > 22 mmol/l)
  • Potassium wasting diuretics (e.g. thiazides)
  • Avoid salt substitutes which may be high in K+
  • Cease ACE inhibitors/ARBs/Spironolactone if K+ persistently >6.0 mmol/l and not responsive to above therapies
  • Refer to nearest emergency departement if K+>6.5 mmol/l

About azaleaazelia

A nice person... :)
This entry was posted in Tak Berkategori. Bookmark the permalink.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s