Hyperkalemia: Difference between revisions
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In [[medicine]], '''hyperkalemia''' is an "abnormally high [[potassium]] concentration in the blood, most often due to defective renal excretion. It is characterized clinically by [[electrocardiogram|electrocardiographic]] abnormalities (elevated T waves and depressed P waves, and eventually by atrial asystole). In severe cases, weakness and flaccid paralysis may occur."<ref>{{MeSH}}</ref> | In [[medicine]], '''hyperkalemia''' is an "abnormally high [[potassium]] concentration in the blood, most often due to defective renal excretion. It is characterized clinically by [[electrocardiogram|electrocardiographic]] abnormalities (elevated T waves and depressed P waves, and eventually by atrial asystole). In severe cases, weakness and flaccid paralysis may occur."<ref>{{MeSH}}</ref> | ||
Severe hyperkalemia is a life-threatening condition; indeed, intravenous [[potassium chloride]] is used to stop the heart both for [[open-heart surgery]] and [[lethal execution]]. | |||
==Treatment== | ==Treatment== | ||
Treatment includes both emergency and continued therapy. | Treatment includes both emergency and continued therapy. | ||
===Emergency | ===Emergency management=== | ||
[[ | Intravenous [[insulin]] with [[glucose]], and inhaled [[adrenergic beta-agonist]]s, used separately or together, are established therapies for lowering potassium levels. <ref name=AFP>{{citation | ||
| url = http://www.aafp.org/afp/2006/0115/p283.html | | url = http://www.aafp.org/afp/2006/0115/p283.html | ||
| journal = American Family Physician | | journal = American Family Physician | ||
| Line 10: | Line 13: | ||
| author = Joyce C. Hollander-Rodriguez and James F. Calvert | | author = Joyce C. Hollander-Rodriguez and James F. Calvert | ||
| date = 2006 Jan 15| volume = 73| issue = 2 | pages =283-290}}</ref> | | date = 2006 Jan 15| volume = 73| issue = 2 | pages =283-290}}</ref> | ||
=== | ===Continued lowering=== | ||
Sodium polystyrene sulfonate (Kayexalate) is widely used for continued lowering of potassium levels. While the resin proper is considered safe, the available preparations with it suspended in [[sorbitol]] may be dangerous. <ref name="pmid20167700">{{cite journal| author=Sterns RH, Rojas M, Bernstein P, Chennupati S| title=Ion-exchange resins for the treatment of hyperkalemia: are they safe and effective? | journal=J Am Soc Nephrol | year= 2010 | volume= 21 | issue= 5 | pages= 733-5 | pmid=20167700 | Sodium polystyrene sulfonate (Kayexalate) is widely used for continued lowering of potassium levels. While the resin proper is considered safe, the available preparations with it suspended in [[sorbitol]] may be dangerous. <ref name="pmid20167700">{{cite journal| author=Sterns RH, Rojas M, Bernstein P, Chennupati S| title=Ion-exchange resins for the treatment of hyperkalemia: are they safe and effective? | journal=J Am Soc Nephrol | year= 2010 | volume= 21 | issue= 5 | pages= 733-5 | pmid=20167700 | ||
| url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=clinical.uthscsa.edu/cite&retmode=ref&cmd=prlinks&id=20167700 | doi=10.1681/ASN.2010010079 }} </ref><ref name="pmid19373153">{{cite journal| author=McGowan CE, Saha S, Chu G, Resnick MB, Moss SF| title=Intestinal necrosis due to sodium polystyrene sulfonate (Kayexalate) in sorbitol. | journal=South Med J | year= 2009 | volume= 102 | issue= 5 | pages= 493-7 | pmid=19373153 | | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=clinical.uthscsa.edu/cite&retmode=ref&cmd=prlinks&id=20167700 | doi=10.1681/ASN.2010010079 }} </ref><ref name="pmid19373153">{{cite journal| author=McGowan CE, Saha S, Chu G, Resnick MB, Moss SF| title=Intestinal necrosis due to sodium polystyrene sulfonate (Kayexalate) in sorbitol. | journal=South Med J | year= 2009 | volume= 102 | issue= 5 | pages= 493-7 | pmid=19373153 | ||
| url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=clinical.uthscsa.edu/cite&retmode=ref&cmd=prlinks&id=19373153 | doi=10.1097/SMJ.0b013e31819e8978 }} </ref> | | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=clinical.uthscsa.edu/cite&retmode=ref&cmd=prlinks&id=19373153 | doi=10.1097/SMJ.0b013e31819e8978 }} </ref> | ||
It may be accompanied by intravenous [[furosemide]] in saline. <ref name=AFP/> | |||
==References== | ==References== | ||
{{reflist|2}} | |||
Revision as of 22:21, 14 June 2010
In medicine, hyperkalemia is an "abnormally high potassium concentration in the blood, most often due to defective renal excretion. It is characterized clinically by electrocardiographic abnormalities (elevated T waves and depressed P waves, and eventually by atrial asystole). In severe cases, weakness and flaccid paralysis may occur."[1]
Severe hyperkalemia is a life-threatening condition; indeed, intravenous potassium chloride is used to stop the heart both for open-heart surgery and lethal execution.
Treatment
Treatment includes both emergency and continued therapy.
Emergency management
Intravenous insulin with glucose, and inhaled adrenergic beta-agonists, used separately or together, are established therapies for lowering potassium levels. [2]
Continued lowering
Sodium polystyrene sulfonate (Kayexalate) is widely used for continued lowering of potassium levels. While the resin proper is considered safe, the available preparations with it suspended in sorbitol may be dangerous. [3][4]
It may be accompanied by intravenous furosemide in saline. [2]
References
- ↑ Anonymous (2024), Hyperkalemia (English). Medical Subject Headings. U.S. National Library of Medicine.
- ↑ 2.0 2.1 Joyce C. Hollander-Rodriguez and James F. Calvert (2006 Jan 15), "Hyperkalemia", American Family Physician 73 (2): 283-290
- ↑ Sterns RH, Rojas M, Bernstein P, Chennupati S (2010). "Ion-exchange resins for the treatment of hyperkalemia: are they safe and effective?". J Am Soc Nephrol 21 (5): 733-5. DOI:10.1681/ASN.2010010079. PMID 20167700. Research Blogging.
- ↑ McGowan CE, Saha S, Chu G, Resnick MB, Moss SF (2009). "Intestinal necrosis due to sodium polystyrene sulfonate (Kayexalate) in sorbitol.". South Med J 102 (5): 493-7. DOI:10.1097/SMJ.0b013e31819e8978. PMID 19373153. Research Blogging.