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The management of hyperkalaemia in the emergency department
  1. Peter Ahee1,
  2. Alexander V Crowe2
  1. 1Department of Accident and Emergency Medicine, City Hospital, Birmingham
  2. 2Department of Nephrology, Royal Liverpool University Hospital
  1. Correspondence to: Dr Crowe, Senior Registrar in Nephrology, 6C Link, The Renal Unit, Royal Liverpool University Hospital, Prescot Street, Liverpool L7 8XP (e-mail: acrowe{at}


Life threatening hyperkalaemia (> 7.0 mmol/l ) is commonly associated with acute renal failure. Moderate hyperkalaemia ( 6.1–6.9 mmol/l ) is also common and well tolerated in patients with chronic renal failure. Renal failure is the most common cause of hyperkalaemia although other causes to consider include drugs (potassium sparing diuretics, angiotensin converting enzyme inhibitors), hyperglycaemia, rhabdomyolysis and adrenal insufficiency. Hyperkalaemia affects the cardiac conducting tissue and can cause serious arrhythmias including ventricular fibrillation and asystolic arrest. Therefore it is important to treat hyperkalaemia promptly in the emergency department. This paper evaluates the therapeutic options available for treatment of hyperkalaemia.

  • hyperkalaemia
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  • Funding: none.

  • Conflicts of interest: none.

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