Hyperkalemia in dialysis patients

Semin Dial. Sep-Oct 2001;14(5):348-56. doi: 10.1046/j.1525-139x.2001.00087.x.

Abstract

Serious hyperkalemia is common in patients with end-stage renal disease (ESRD) and accounts for considerable morbidity and death. Mechanisms of extrarenal disposal of potassium (gastrointestinal excretion and cellular uptake) play a crucial role in the defense against hyperkalemia in this population. In this article we review extrarenal potassium homeostasis and its alteration in patients with ESRD. We pay particular attention to the factors that influence the movement of potassium across cell membranes. With that background we discuss the emergency treatment of hyperkalemia in patients with ESRD. We conclude with a review of strategies to reduce the risk of hyperkalemia in this population of patients.

Publication types

  • Review

MeSH terms

  • Acid-Base Equilibrium / physiology
  • Adrenergic beta-Agonists / pharmacology
  • Albuterol / pharmacology
  • Aldosterone / metabolism
  • Calcium / physiology
  • Catecholamines / metabolism
  • Cation Exchange Resins
  • Digestive System / metabolism
  • Extracellular Space / metabolism
  • Homeostasis
  • Humans
  • Hyperkalemia / etiology*
  • Hyperkalemia / prevention & control
  • Intracellular Fluid / metabolism
  • Kidney Failure, Chronic / complications*
  • Kidney Failure, Chronic / physiopathology
  • Kidney Failure, Chronic / therapy
  • Potassium / metabolism*
  • Potassium / physiology
  • Renal Dialysis*

Substances

  • Adrenergic beta-Agonists
  • Catecholamines
  • Cation Exchange Resins
  • Aldosterone
  • Albuterol
  • Potassium
  • Calcium