Medicine notes - #Hyperkalemia
(first episode of medical topics that are relevant to me and I repeat for myself as personal notes)
Def: >6.5 mmol/l (maybe earlier; depending on chronicity an patient status)
Causes: CKD, Medication (ACEi, ARB, MRA,..), Addison, Diabetes, Acidosis, Crush, Myolsis,..
Why treat: u-shaped mortality curve for potassium, sweet-spot around 4,5 mmol/l
Workup: Discriminate pseudohyper-K, EKG, monitoring
Treatment:
-identify cause
-save the heart (Calciumgluconate 10% 10ml in 10min), not with Digitalis
-move K+ into cells: Bicarb 8,4% 50ml, Insulin-Glucose (5IE Insulin in 500ml Ringers with 6-12 Amps G40%)
- move K+ out of body: Furosemide i.v., potassium binders: newest: Lokelma (ZSC) 3x10g p.o
- if not responding: DIALYSIS
Recommended reading german pin-up-docs.de/2019/11/04/akut…
Recommended reading english: ERC guidelines 2021 cprguidelines.eu/guidelines-20…