Journal article
Clinical Management of Hyperkalemia
Mayo Clinic proceedings, v 96(3), pp 744-762
Mar 2021
PMID: 33160639
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Hyperkalemia is an electrolyte abnormality with potentially life-threatening consequences. Despite various guidelines, no universally accepted consensus exists on best practices for hyperkalemia monitoring, with variations in precise potassium (K
) concentration thresholds or for the management of acute or chronic hyperkalemia. Based on the available evidence, this review identifies several critical issues and unmet needs with regard to the management of hyperkalemia. Real-world studies are needed for a better understanding of the prevalence of hyperkalemia outside the clinical trial setting. There is a need to improve effective management of hyperkalemia, including classification and K
monitoring, when to reinitiate previously discontinued renin-angiotensin-aldosterone system inhibitor (RAASi) therapy, and when to use oral K
-binding agents. Monitoring serum K
should be individualized; however, increased frequency of monitoring should be considered for patients with chronic kidney disease, diabetes, heart failure, or a history of hyperkalemia and for those receiving RAASi therapy. Recent clinical studies suggest that the newer K
binders (patiromer sorbitex calcium and sodium zirconium cyclosilicate) may facilitate optimization of RAASi therapy. Enhancing the knowledge of primary care physicians and internists with respect to the safety profiles of these newer K
binders may increase confidence in managing patients with hyperkalemia. Lastly, the availability of newer K
-binding agents requires further study to establish whether stringent dietary K
restrictions are needed in patients receiving K
-binder therapy. Individualized monitoring of serum K
among patients with an increased risk of hyperkalemia and the use of newer K
-binding agents may allow for optimization of RAASi therapy and more effective management of hyperkalemia.
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Details
- Title
- Clinical Management of Hyperkalemia
- Creators
- Biff F Palmer - The University of Texas Southwestern Medical CenterJuan Jesus Carrero - Karolinska InstitutetDeborah J Clegg - Drexel UniversityGates B Colbert - Baylor University Medical CenterMichael Emmett - Baylor University Medical CenterSteven Fishbane - Hofstra UniversityDebra J Hain - Florida Atlantic UniversityEdgar Lerma - Advocate Christ Medical CenterMacaulay Onuigbo - University of Vermont Medical CenterAnjay Rastogi - University of California, Los AngelesSimon D Roger - Gosford HospitalBruce S Spinowitz - Nephrology Associates P.C., New Rochelle, NY.Matthew R Weir - University of Maryland, Baltimore
- Publication Details
- Mayo Clinic proceedings, v 96(3), pp 744-762
- Publisher
- Elsevier
- Resource Type
- Journal article
- Language
- English
- Web of Science ID
- WOS:000632259400028
- Scopus ID
- 2-s2.0-85095573154
- Other Identifier
- 991019357625904721
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- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Cardiac & Cardiovascular Systems