How do you treat hyperkalemia?

As a medical professional with expertise in treating electrolyte imbalances, I can provide you with an overview of how to treat hyperkalemia, which is a condition characterized by elevated levels of potassium in the blood. **Step 1: Assess the severity of hyperkalemia.** The treatment approach depends on the severity of the condition and the presence of symptoms. Mild hyperkalemia may not require immediate intervention, but severe cases can be life-threatening and require urgent treatment. Step 2: Remove excess potassium. There are several strategies to remove excess potassium from the body: - Dietary restrictions: Limiting foods high in potassium can help reduce potassium intake. - Diuretics: Certain diuretics can increase potassium excretion through urine. - Cation exchange resins: These bind to potassium in the gut and facilitate its removal from the body. Step 3: Shift potassium into cells. To lower serum potassium levels quickly, without removing the potassium from the body, you can use: - Insulin: Given with glucose to drive potassium into cells. - Sodium bicarbonate: This can also shift potassium into cells and correct acidosis if present. Step 4: Treat the underlying cause. Addressing the cause of hyperkalemia is crucial. This may involve adjusting medications that contribute to potassium retention or treating the underlying medical condition causing the imbalance. Step 5: Monitor and follow up. Regular monitoring of potassium levels and electrolyte balance is essential to ensure the treatment is effective and to prevent recurrence. Safety Measures: - Avoid potassium-sparing diuretics: These can exacerbate hyperkalemia. - Monitor kidney function: As kidney impairment can lead to hyperkalemia, it's important to monitor renal function. Emergency Treatment: In cases of severe hyperkalemia with ECG changes or symptoms, immediate measures include: - Calcium gluconate: To stabilize the cell membrane and protect the heart. - Insulin and dextrose: To shift potassium into cells. - Sodium bicarbonate: If acidosis is present. - Nebulized albuterol: This can also facilitate potassium shift into cells.

Discontinue medications that increase blood potassium levels. Intravenous administration of glucose and insulin, which promotes movement of potassium from the extracellular space back into the cells. Intravenous calcium to temporarily protect the heart and muscles from the effects of hyperkalemia.