The Curbsiders Internal Medicine Podcast #199 NephMadness: Hyperkalemia, Diet, Potassium Binders, Exercise
Mar 16, 2020
Dr. Ryann Sohaney, Dr. Deborah Clegg, and Dr. Joel Topf discuss hyperkalemia in CKD in this episode. They examine the use of potassium binders, challenge low-potassium diets, and explore the influence of exercise on serum potassium. They also introduce NephMadness 2020 and discuss managing hyperkalemia, dietary changes, salt substitutes, and the benefits of exercise for CKD patients.
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Hyperkalemia in CKD Insight
- Hyperkalemia is the most common electrolyte issue in CKD, affecting up to 20% with lower GFR increasing risk.
- Diabetes and heart failure patients are more prone due to insulin resistance and medication effects.
Check Meds Before Stopping
- Always review medications for hyperkalemia causes, especially ACE inhibitors and ARBs.
- Do not stop these meds prematurely; consider potassium binders first to maintain therapy.
Identify Hidden Potassium Sources
- Probe for herbal supplements or unusual dietary items as hidden potassium sources.
- Watch for common offenders like NSAIDs, potassium-sparing diuretics, and trimethoprim.