👉Involve allied healthcare professionals Strive for maximum tolerated RAASi therapy! Treat hyperkalemia & reinitiate RAASi after resolution, then reassess K level within 1 wkġ3) Patient education is🔑: recommends⬆️patient awareness of hyperK For those on dialysis, long interdialytic gap ↑hyperkalemia chances #NephroNotes #NephPearlsġ0) This table is a nice summary of causes and treatment of hyperkalemia across continuum of kidney function, from 🔓 #NephroNotes #NephPearls #FOAMed #MedEdġ1) A low-K diet is generally recommended in advanced #CKD, but suggests interventional trials to determine optimal recommendations, as there is no direct evidence to link dietary K & serum K, and the benefits of K can’t be ignoredġ2) Guidelines for use of #RAAS inhibitors are intertwined with K homeostasis.
#CKD patients have multiple risk factors for hyperkalemia. 🔓 #NephroNotes #NephPearls #FOAMed #MedEdĩ) So let's focus on #hyperkalemia in #CKD ➡️adverse outcomes, as it restricts RAASi & MRA usage.
In #CKD, relative risk of hyperK approximately doubles for every⬇️in eGFR of 15 mL/minĨ) Because it may be unexpected, we must be especially cautious of drug-induced hyperkalemia Mortality risk is independent of symptoms, but not ECG findings, as bradycardia/junctional rhythm/QRS widening→Poor outcome.ħ) There are multiple causes of #hyperkalemia: #NephroNotes #NephPearls #FOAMed #MedEd #CardioTwitterĤ) Re potassium #homeostasis: 98% of the body's K lies in intracellular space➡️ helping determine resting membrane potential & intracellular electronegativity.ġ0% of K secretion is via the colon (↑significantly in advancing CKD) 🔓 #NephroNotesĥ) There is debate abt the definition of hyperK (>5? >5.5?), but it is classified by serum K & ECG. The periodic table symbol K was derived from kali (alkali). Educational credit for #physicians #physicianassociate #nurses #nursepractitioners #pharmacists 🇺🇸🇨🇦🇪🇺🇬🇧ģ) Potassium first isolated by Humphry Davy in 1807 by electrolysis (Coined word from “Potash” ). I am Sourabh Sharma MD DNB FASN 🇮🇳 & u have found the ONLY source for CE credit delivered entirely on Twitter!Ģ) This program is supported by educational grants from AstraZeneca, Bayer, & Chiesi & is intended for #healthcare providers. Earn 0.5h #CME/CE credit by following this thread. 1) Welcome to our #accredited #tweetorial on optimal mgt of #hyperkalemia in the patient with #CKD.
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