HYPERKALEMIA (ELECTROLYTE IMBALANCE)

HYPERKALEMIA

  • It is an elevated level potassium(k+) in blood(above 5.5mEq/L)
  • Normal potassium level 3.5 - 5mmol/L (3.5 - 5 mEq/L)
  • Potassium level >8.0 mEq causes diastolic arrest


CAUSES:

  • Pseudo hyperkalemia : fist clenching, narrow bore needle, cooling of sample, TLC↑, platelet↑, RBC↑
  • Acidosis,Trans-cellular shift
  • CKD/AKI
  • Aldosterone↓ - Addison disease, histoplasmosis, HIV, waterhouse frederickson syndrome
  • Gordon syndrome- gain of  NACL cotransport


WORKUP:
  • Increase potassium


  • ECG: a)Tall peaked T wave
  • b)ST segment depressed
  • c)P wave - wide, flat
  • d)QRS widened



TREATMENT:
  • Antagonism: Ca gluconate (usually used),Ca chloride (best)

  • Redistribution: Insulin drip with 50% dextrose,salbutamol nebulization

  • Removal of potassium: Furosemide,Resin sodium polystyrene sulphonate, PATIROMER(potassium binding agent), ZS - 9(sodium zirconium cyclosilicate)




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