{"id":1282,"date":"2017-06-19T07:15:31","date_gmt":"2017-06-19T07:15:31","guid":{"rendered":"http:\/\/papergp.com\/index.php\/data-interpretation\/ues\/hyperkalaemia\/"},"modified":"2023-01-24T11:25:25","modified_gmt":"2023-01-24T11:25:25","slug":"hyperkalaemia","status":"publish","type":"page","link":"https:\/\/papergp.com\/index.php\/data-interpretation\/ues\/hyperkalaemia\/","title":{"rendered":"Hyperkalaemia"},"content":{"rendered":"<div class=\"content-box-blue\">\n<h4>Background<\/h4>\n<ul>\n<li>Assess severity\n<ul>\n<li>Mild &#8211; K+ 5.5-6.0 mmol\/L<\/li>\n<li>Possible emergency &#8211; K+ 6.1-6.9\u00a0mmol\/L<\/li>\n<li>Usually an emergency &#8211; K+ &gt;7.0\u00a0mmol\/L\n<ul>\n<li>Above needs to be taken into context, if sudden rise with AKI, more likely to be significant<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<li>Symptoms\n<ul>\n<li>Arrhythmias<\/li>\n<li>Muscle weakness, paraesthesia, fatigue<\/li>\n<\/ul>\n<\/li>\n<li>ECG changes\n<ul>\n<li>peaked T waves, widening QRS complex<\/li>\n<\/ul>\n<\/li>\n<li>Causes\n<ul>\n<li>Pseudohyperkalaemia\n<ul>\n<li>contamination from FBC tube, delayed arrival of specimen at lab, storage at low tempreatures, leakage from platelets, difficult sample collection<\/li>\n<\/ul>\n<\/li>\n<li>Medications\n<ul>\n<li>ACE, ARB<\/li>\n<li>Potassium supplements<\/li>\n<li>Potassium sparing diuretics &#8211; spironolactone, amiloride<\/li>\n<li>NSAIDs<\/li>\n<li>Trimethoprim<\/li>\n<li>Heparin<\/li>\n<li>Beta blockers<\/li>\n<\/ul>\n<\/li>\n<li>AKI\/CKD (usually stage 4+)<\/li>\n<li>Diabetic nephropathy<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/div>\n<p>&nbsp;<\/p>\n<div class=\"content-box-blue\">\n<h4>Data gathering<\/h4>\n<ul>\n<li>Red flags &#8211;\u00a0muscle weakness, paralysis, paraesthesia, fatigue<\/li>\n<li>Others &#8211; medications, passing urine<\/li>\n<\/ul>\n<\/div>\n<p>&nbsp;<\/p>\n<div class=\"content-box-blue\">\n<h4>Clinical management<\/h4>\n<ul>\n<li>K+ 5.5 &#8211; 5.9\n<ul>\n<li>Repeat K+ within 1-2 weeks<\/li>\n<li>Review medications, renal function<\/li>\n<li>Take more seriously if\n<ul>\n<li>sudden decrease in eGFR<\/li>\n<li>rise &gt; 0.5 mmol\/L<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<li>K+ 6.0 &#8211; 7.0\n<ul>\n<li>Recheck as soon as possible<\/li>\n<li>Stop contributing medications<\/li>\n<li>ECG<\/li>\n<li>Consider referral to AAU (not A+E) depending on:\n<ul>\n<li>clinical state of patient<\/li>\n<li>arrhythmia<\/li>\n<li>muscle weakness, paralysis, paraesthesia, fatigue<\/li>\n<li>ECG changes<\/li>\n<li>rapid fall in eGFR<\/li>\n<li>rapid increase in potassium (&gt;0.5 mmol\/L within 2 weeks)<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<li>K+ 7.0\n<ul>\n<li>refer to hospital (avoid A+E unless acutely unwell)<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>Background Assess severity Mild &#8211; K+ 5.5-6.0 mmol\/L Possible emergency &#8211; K+ 6.1-6.9\u00a0mmol\/L Usually an emergency &#8211; K+ &gt;7.0\u00a0mmol\/L Above needs to be taken into context, if sudden rise with AKI, more likely to be significant Symptoms Arrhythmias Muscle weakness, paraesthesia, fatigue ECG changes peaked T waves, widening QRS complex Causes Pseudohyperkalaemia contamination from FBC &hellip; <a href=\"https:\/\/papergp.com\/index.php\/data-interpretation\/ues\/hyperkalaemia\/\" class=\"more-link\">Continue reading <span class=\"screen-reader-text\">Hyperkalaemia<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"parent":1269,"menu_order":14,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-1282","page","type-page","status-publish","hentry"],"jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages\/1282","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/comments?post=1282"}],"version-history":[{"count":2,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages\/1282\/revisions"}],"predecessor-version":[{"id":1285,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages\/1282\/revisions\/1285"}],"up":[{"embeddable":true,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages\/1269"}],"wp:attachment":[{"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/media?parent=1282"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}