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Hyperkalemia_Management_Presentation.pptx
- 1. Hyperkalemia and Its Management DrSheraz Hamayun PGR Urology Department SGRH
- 2. DEFINITION It is definedas serum potassium concenteration of greater than 5.5 mEq/L. The normal concenteration of serum potassium range from 3.5-5.o mEq/L.
- 3. Classification Mild hyperkalemia 5.5-6.0mEq/L. Moderate hyperkalemia 6.1-6.9 mEq/L. Severe hyperkalemia greater than 7.
- 4. Etiology of Hyperkalemia Increased intake (rare) Impaired renal excretion (CKD,ARF, Medications, Diseases) Cellular redistribution (acidosis, rhabdomyolysis, Insulin deficiency) Tubular unresponsiveness to Aldosterone.
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- 6. ECG Changes inHyperkalemia Tall peaked T waves Widened QRS Prolonged PR Sine wave pattern in severe cases
- 8. Diagnosis Serum electrolytes Renal function test ABGs ECG monitoring Urine Osmolality
- 9. Management Overview Three stepsto manage : 1. Cardiac stabilization 2. Shift K+ intracellularly 3. Remove K+ from body
- 10. Step 1 –Cardiac Stabilization Iv 1oml of 10% calcium gluconate Route slow intravenous push over 2-5 mins with cardiac monitoring. Onset: Immediate Duration: ~30–60 min Stabilizes myocardium
- 11. Step 2 –Shift K+ Intracellularly 10 units of regular Insulin Iv + 25 g of Dextrose given as: 5oml of 50% dextrose 100ml of 25 % dextrose 25oml of 10 % dextrose 500ml of 5% dextrose Insulin transpots about 0.6 to 1.2 mEq/L of potassium.
- 12. Beta-agonists (Inhaledalbuterol) Dose: 10–20 mg via nebulizer Route: Inhalation Time: Over 10–20 minutes Onset: ~30 minutes Duration: 2–4 hours– 20mg
- 13. Sodium Bicarbonate Dose :50–100 mEq IV Commonly: 50 mEq in 50 mL of D5W (or sterile water) Route: IV over 5–10 minutes (can also be infused over 30–60 min) May be repeated based on ABG results and potassium levels
- 14. Step 3 –Eliminate Potassium Loop diuretics (furosemide) Dose: 20 mg to 40 mg iv 40 mg to 80mg po Onset: 5 mins iv 30 – 60 min Duration: 4-6 hours Thiazide diuretics ( hydrochlorthiazide) Dose: 12.5-25 mg orally once daily
- 15. Cation exchangeresins ( sodium polyesterene sulfonate) Dose: 15 – 60 g orally four times a day 30 – 50 g per rectal every six hourly Onset: 2-6 hours Duration: 4-6 hours Hemodialysis Hyperkalemia more than 6.5 with Ecg changes not responding to medical therapy.
- 17. Prevention Strategies MonitorK+ in at-risk patients Avoid high-K+ foods in CKD Educate on warning signs
- 18. Summary Hyperkalemia =emergency Requires prompt diagnosis and treatment Focus on stabilization, shift, elimination
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