Hyperkalemia in Patients on Maintenance Dialysis: How to Deal with?
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Dr Guliver Potsangbam, Imphal 27 December 2018
Dialysis patients are more tolerant of hyperkalemia.
Avoiding serum/dialysate K mismatches - ↓ dialysis-associated arrhythmias and SD.
Attention to concomitant dialytic factors and manipulating colonic K secretion. Prevention largely upon compliance with diet and use of medication regimens.
Determining urgency of therapy - Hyperkalemic emergency: Cardiac conduction abnormalities/arrhythmia; muscle weakness/paresis; require rapidly acting therapy/dialysis. Patients needing prompt therapy: K lowered within 6-12 hours; dialysis patients presenting outside of regular dialysis hours/optimization for surgery.
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