Core IM | Internal Medicine Podcast

#93 Hyperkalemia in CKD: Mind the Gap Segment

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Nov 17, 2021
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ADVICE

ED Referral for Hyperkalemia

  • For potassium levels over 6.0 mEq/L, send the patient to the ED, especially if the increase is sudden.
  • If the potassium is below 6.0 mEq/L, but increased rapidly from normal, it should also be taken seriously.
INSIGHT

EKG Changes in Hyperkalemia

  • EKG changes are not a reliable indicator of hyperkalemia severity.
  • A normal EKG doesn't rule out risk, as changes can appear later, even with very high potassium.
ANECDOTE

Case Report: Delayed EKG Changes

  • A 77-year-old patient had a potassium level of 8.5 with a normal EKG.
  • Six days later, with potassium again at 8.6, he developed a sine wave pattern on EKG.
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