title: Treatment of life-threatening hyperkalemia with peritoneal dialysis in the ED.
abstract: Severe hyperkalemia (serum potassium N 7.0 mmol/L) is an uncommon electrolyte abnormality in patients undergoing maintenance peritoneal dialysis (PD). Hemodialysis (HD) has been suggested as the definitive therapy for severe hyperkalemia in this population,although there is limited data regarding renal replacement options.We report a case of life-threatening hyperkalemia with electrocardiogram changes in a nonadherent PD patient who was successfully treated with standard medical therapy and manual exchanges initiated by emergency department (ED) personnel. The patient did not require HD. This case demonstrates the potential utility of PD as a treatment option for severe hyperkalemia in established dialysis patients when EDs are prepared to deliver exchanges. This report maybe particularly relevant due to the increasing prevalence rate of PD and for centers with limited HD access.
authors.affiliation: Renal Section, Department of Medicine, Boston University Medical Center, Boston, MA, USA.
authors.forename: Daniel A
authors.initials: DA
authors.lastname: Roseman
authors.affiliation: Department of Emergency Medicine, Boston University Medical Center, Boston, MA, USA.
authors.forename: Elissa M
authors.initials: EM
authors.lastname: Schechter-Perkins
authors.affiliation: Renal Section, Department of Medicine, Boston University Medical Center, Boston, MA, USA. Electronic address: jbhatia@bu.edu.
authors.forename: Jasvinder S
authors.initials: JS
authors.lastname: Bhatia
mesh_terms: D004636:Emergency Service, Hospital; D006801:Humans; D006947:Hyperkalemia / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis / Q000379:methods*