BMJ Best Practice Podcast Hyperkalemia
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Mar 13, 2025 Sri Yarlagadda, an Associate Professor in the Division of Nephrology at the University of Kansas Medical Center, dives into the complexities of hyperkalemia. He discusses its serious implications, including life-threatening cardiac arrhythmias, emphasizing the importance of accurate assessment and diagnosis. The impact of sample integrity on test results is highlighted, along with challenges in managing potassium levels, particularly in palliative care. Yarlagadda also shares insights on dietary considerations and the distinctive signs of conditions like Addison's disease.
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Initial Steps for Hyperkalemia
- First, confirm that the sample isn't hemolyzed, as this can cause a false positive.
- Then, assess the degree of hyperkalemia and check serum bicarbonate and glucose levels.
Understanding Bicarbonate and Potassium Levels
- Low serum bicarbonate with high potassium suggests an outward shift of potassium from cells.
- This type of hyperkalemia is generally easier to correct by shifting potassium back into cells.
Common Causes of Hyperkalemia
- Consider impaired potassium elimination or excessive production/release.
- Common causes include renal insufficiency, diabetic ketoacidosis, crush injuries, rhabdomyolysis, and tumor lysis syndrome.