Document Detail

Management of severe hyperkalemia without hemodialysis: case report and literature review.
MedLine Citation:
PMID:  17175417     Owner:  NLM     Status:  MEDLINE    
PURPOSE: To report a case of severe hyperkalemia successfully managed without the use of hemodialysis and to provide a review of the literature regarding the management of severe hyperkalemia. METHODS: A clinical case report from the medical-surgical intensive care unit of a teaching hospital and a literature review are presented. The case involves a 59-year old man with diabetes mellitus, essential hypertension, and gout, who presented to hospital with severe hyperkalemia (K(+) = 10.4 mEq/L) and normal renal function. He was treated with intravenous fluids, sodium bicarbonate, calcium chloride, insulin, calcium resonium, and furosemide. RESULTS: The hyperkalemia resolved with conservative treatment within 8 hours, and dialytic therapy was not required. The literature review supported an initial conservative management approach in stable patients with intact renal function. CONCLUSIONS: Hemodialysis is not necessary for all cases of severe hyperkalemia and should be reserved for patients with acute or chronic renal failure or those with life-threatening hyperkalemia unresponsive to more conservative measures.
Virginia Carvalhana; Lisa Burry; Stephen E Lapinsky
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Publication Detail:
Type:  Case Reports; Journal Article; Review    
Journal Detail:
Title:  Journal of critical care     Volume:  21     ISSN:  0883-9441     ISO Abbreviation:  J Crit Care     Publication Date:  2006 Dec 
Date Detail:
Created Date:  2006-12-18     Completed Date:  2007-03-13     Revised Date:  2008-12-11    
Medline Journal Info:
Nlm Unique ID:  8610642     Medline TA:  J Crit Care     Country:  United States    
Other Details:
Languages:  eng     Pagination:  316-21     Citation Subset:  IM    
Department of Pharmacy, Mount Sinai Hospital, Toronto, ON, Canada M5G 1X5.
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MeSH Terms
Bradycardia / etiology
Fluid Therapy / methods*
Hyperkalemia / complications,  therapy*
Middle Aged
Renal Dialysis
Treatment Outcome
Comment In:
J Crit Care. 2008 Sep;23(3):431-3   [PMID:  18725051 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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