Episode Description:
Hyperkalemia, characterized by elevated serum potassium levels, arises in CKD due to the kidneys’ reduced ability to excrete potassium, leading to its accumulation in the blood. This episode delves into how impaired kidney function, metabolic acidosis, and the use of certain medications contribute to hyperkalemia in CKD patients.
Several factors increase the risk of hyperkalemia in CKD patients, including the severity of kidney dysfunction, use of medications like RAAS inhibitors and potassium-sparing diuretics, high dietary potassium intake, and comorbid conditions such as diabetes mellitus and heart failure. Older adults are particularly at risk due to decreased renal function and comorbidities.
Hyperkalemia symptoms can range from mild to severe, including muscle weakness, fatigue, paresthesia, and cardiac arrhythmias, with severe cases leading to cardiac arrest. Early detection and management are critical.
Diagnosing hyperkalemia involves measuring serum potassium levels, with levels above 5.0 mmol/L indicating hyperkalemia. Electrocardiogram changes help determine the severity and guide treatment decisions.
Management of hyperkalemia in CKD patients involves both acute and long-term strategies. Acute management includes stabilizing the myocardium with intravenous calcium gluconate and shifting potassium intracellularly using insulin and glucose, beta-agonists, and sodium bicarbonate in cases of acidosis. Potassium removal can be achieved with diuretics, sodium polystyrene sulfonate, and dialysis in severe cases.
Long-term strategies focus on dietary modifications, educating patients on low-potassium diets, and adjusting medications that contribute to hyperkalemia. Newer potassium binders, such as patiromer and sodium zirconium cyclosilicate, offer effective long-term management options. Regular monitoring of serum potassium levels, kidney function, and medication review is essential to prevent hyperkalemia.
Renes Care Radio is a podcast designed for nephrology professionals, offering in-depth scientific explorations of key topics. It equips kidney care providers with the essential knowledge needed for advanced patient care.
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This podcast is for informational purposes only and is not intended to replace professional medical advice, diagnosis, or treatment.