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Hyperkalemia Hypokalemia - Differential Diagnosis and Management Algorithm

Dr Pravin Patel

#Hypokalemia #Hyperkalemia #potassium #differential #diagnosis #management
Hyperkalemia Hypokalemia ... Diagnosis and Management ... #Hyperkalemia # ... potassium #differential ... #diagnosis #management
Emergency management of severe hyperkalemia

#hyperkalemia #management #algorithm #nephrology #Potassium #Treatment
Emergency management ... of severe hyperkalemia ... #hyperkalemia ... #management #algorithm ... #nephrology #Potassium
Hyperkalemia: Diagnostic algorithm
Decreased renal potassium excretion
 • Acute renal failure
 • Chronic renal failure
 • Drugs
Increased
Hyperkalemia: Diagnostic ... Decreased renal potassium ... Drugs Increased potassium ... • Tumor lysis/hemolysis ... • Type 1 #Hyperkalemia
Hyperkalemia Differential Diagnosis Algorithm
R/O Pseudo-hyperkalemia:
 • Possible Lab error! Alwavs Repeat Blood sample!
 • Leukocytosis, Thrombocytosis:
Hyperkalemia Differential ... Algorithm R/O Pseudo-hyperkalemia ... ischemia-induced RBC hemolysis ... ) • RBC Hemolysis ... Algorithm #causes #potassium
EKG showing prominent U waves due to hypokalemia. Serum potassium 2.0. 

#EKG #emergencymedicine #criticalcare #cardiology #internalmedicine
U waves due to hypokalemia ... Serum potassium ... emergencymedicine #criticalcare
Checklist Approach to Hypokalemia

Consider risk factors for arrhythmia:
 - EKG changes (especially QT prolongation)
 - Digoxin
Checklist Approach to Hypokalemia ... route = severe hypokalemia ... /hr for severe hypokalemia ... #Checklist #Hypokalemia ... #Management #CriticalCare
Hyperkalemia Management
Membrane Stabilizers:
 • Calcium gluconate
Shifters:
 • Insulin + glucose
 • Albuterol
Excreters:
 • Furosemide
 • Sodium
Hyperkalemia Management ... Medicine @ucsdim #Hyperkalemia ... #Management #Treatment ... #Potassium
Hyperkalemia Treatment Options
Stabilize cardiac membrane:
 • IV Calcium (peaks 5-10 minutes)
Decrease potassium concentration:
 • IV Fluids
Shift
Hyperkalemia Treatment ... minutes) Decrease potassium ... Fluids Shift potassium ... LouLectures #Hyperkalemia ... #management #potassium
Hyperkalemia - Differential Diagnosis Framework

PseudoHyperkalemia:
 • Lab error
 • Traumatic venipuncture
 • Hemolysis, thrombocytosis, leukocytosis
 •
Hyperkalemia - Differential ... venipuncture • Hemolysis ... • Recent IV potassium ... cell lysis: - Hemolysis ... diagnosis #causes #potassium
Treatment of hyperkalemia via kaliuresis 
step 1 = volume resuscitation if hypovolemic
step 2 = consider fludrocortisone
step
Treatment of hyperkalemia ... to diuretic #hyperkalemia ... #kaliuresis #management ... #criticalcare #