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diagnosis hyperkalemia differential management algorithm causes hypokalemia pharmacology binders low binding diuresis diuretics excretion hyponatremia hypotonic kdigo methotrexate physiologic rhabdomyolysis
Hyperkalemia - Differential Diagnosis Framework PseudoHyperkalemia: • Lab error • Traumatic venipuncture • Hemolysis, thrombocytosis, leukocytosis •
phlebotomy High ... • Recent IV potassium ... Medications 2. ... diagnosis #causes #potassium ... #high #nephrology
Hypokalemia - Differential Diagnosis Algorithm Transcellular Shift: • Alkalosis • ↑ beta-2 adrenergic simulation • Erythropoiesis
Thyrotoxicosis Medications ... Renal Losses ... vomiting) • Low K ... Diagnosis #Algorithm #nephrology ... #low #potassium
Hyperkalemia - Differential Diagnosis Framework PseudoHyperkalemia: • Lab error • Traumatic venipuncture • Hemolysis, thrombocytosis, leukocytosis •
phlebotomy High ... • Recent IV potassium ... Medications 2. ... diagnosis #causes #potassium ... #high #nephrology
Hyperkalemia Treatment Options Stabilize cardiac membrane: • IV Calcium (peaks 5-10 minutes) Decrease potassium concentration: • IV Fluids Shift
Hyperkalemia Treatment ... concentration: • IV Fluids ... Shift potassium ... (if preserved renal ... #nephrology
Hypokalemia Evaluation Algorithm Before evaluating hypokalemia, life threatening complications such as arrhythmias and paralysis should be looked
treated with IV potassium ... suggests extra-renal ... urinary losses: • High ... #differential #potassium ... #nephrology #low
Potassium-Binding Agents to Treat Hyperkalemia Sodium zirconium cyclosilicate (Lokelma): • Mechanism: Preferentially captures K in exchange for
Potassium-Binding ... patients sensitive to high ... #Hyperkalemia #medications ... #pharmacology #table ... #comparison #binders
Hyperkalemia - Diagnosis and Management - GrepMed Handbook S/Sx: Most pts asymptomatic. Weakness, cramping, nausea, paresthesias, palpitations,
Etiology: • Medications ... - Renal Failure ... Elimination (see Table ... STOP offending medications ... #potassium #nephrology
Potassium Binders for Management of Hyperkalemia • SPS - Sodium polystyrene sulfonate • Patiromer (veltassa) •
Potassium Binders ... cyclosilicate #Potassium ... #Hyperkalemia #treatment ... #pharmacology #table ... #comparison #nephrology
Diuretics and Agents Regulating Renal Excretion Carbonic Anhydrase Inhibitors (Acetazolamide, Dichlorphenamide) • Glaucoma • Epilepsy • Altitude
Loop Diuretics; High-Ceiling ... Tolvaptan) • Treatment ... Excretion #Diuresis #Nephrology ... #Pharmacology #Medications ... #Table
Physiologic Approach to Hypotonic Hyponatremia The next time you have a case of hypotonic hyponatremia, give the
algorithm Urine Na+K ... ≥100): SIADH, Renal ... diuresis can be high ... differential #diagnosis #table ... #sodium #nephrology
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