Hyperkalaemia: management

Untreated hyperkalaemia may cause life-threatening arrhythmias. Precipitating factors should be addressed (e.g. acute renal failure) and aggravating drugs stopped (e.g. ACE inhibitors). Management may be categorised by the aims of treatment

Stabilisation of the cardiac membrane

• intravenous calcium gluconate

Short-term shift in potassium from extracellular to intracellular fluid compartment

• combined insulin/dextrose infusion
• nebulised salbutamol

Removal of potassium from the body

• calcium resonium (orally or enema)
• loop diuretics
• dialysis