Highlights & Basics
- Hyperkalemia typically presents with no symptoms or with nonspecific features only. However, be aware that some patients with significant hyperkalemia may present with cardiac arrest, which is not covered in this topic.
- Take a detailed past medical and drug history to check for features that increase the risk of hyperkalemia. Confirm hyperkalemia if serum potassium is ≥5.5 mEq/L (≥5.5 mmol/L) and check that this is not due to pseudohyperkalemia.
- Obtain an urgent 12-lead ECG in all hospitalized patients with a serum potassium ≥6.0 mEq/L (≥6.0 mmol/L; or use the threshold in your local protocol) to check for ECG changes that will help to determine the urgency and type of treatment.
- Employ rapidly-acting therapies if hyperkalemia requiring emergency management is present. Target treatment to remove/eliminate potassium from the body, as well as treating the underlying cause of hyperkalemia and any associated disorders.
Quick Reference
History & Exam
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Citations
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Rossignol P, Legrand M, Kosiborod M, et al. Emergency management of severe hyperkalemia: guideline for best practice and opportunities for the future. Pharmacol Res. 2016 Nov;113(pt a):585-91.[Abstract][Full Text]
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