Management of severe hyperkalemia without hemodialysis: case report and literature review.
OBJECTIVE
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.
Carvalhana
Virginia
V
Department of Pharmacy, Mount Sinai Hospital, Toronto, ON, Canada M5G 1X5.
Burry
Lisa
L
Lapinsky
Stephen E
SE
D001919:Bradycardia / Q000209:etiology; D004562:Electrocardiography; D005440:Fluid Therapy / Q000379:methods*; D006801:Humans; D006947:Hyperkalemia / Q000150:complications / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D016896:Treatment Outcome