Podcast 759: Hyperkalemia and Myth of Kayexalate

Podcast 759: Hyperkalemia and Myth of Kayexalate

Contributor: Nick Tsipis, MD

Educational Pearls:

  • Acute hyperkalemia is characterized as serum K of 5.4 or higher in non-hemolyzed samples
  • Hyperkalemia is commonly associated with end stage renal disease, acute kidney injury or acute renal failure
  • Cardiac dysrhythmias are the primary concern with hyperkalemia, common EKG changes (and approximate serum levels) can include:
    • Peaked T waves that start to show at serum K of 6
    • Second sign is lengthening of PR and QRS intervals due to extended repolarization
    • Severe hyperkalemia manifests as a sine wave around serum of 8-9
  • Three approaches to treat hyperkalemia:
    • Stabilize cardiac membrane with calcium
    • Shift potassium back into the cell, insulin and albuterol are common agents used.
    • Potassium binding for excretion
  • Cochrane review showed no significant effects of Kayexalate on serum K in 4 hours
  • Bowel necrosis is a rare adverse event that can occur with Kayexalate
  • More myths and misconceptions about hyperkalemia addressed in reference below!

References:

Gupta AA, Self M, Mueller M, Wardi G, Tainter C. Dispelling myths and misconceptions about the treatment of acute hyperkalemia. Am J Emerg Med. 2022;52:85-91. doi:10.1016/j.ajem.2021.11.030

Mahoney BA, Smith WA, Lo DS, Tsoi K, Tonelli M, Clase CM. Emergency interventions for hyperkalaemia. Cochrane Database Syst Rev. 2005;2005(2):CD003235. Published 2005 Apr 18. doi:10.1002/14651858.CD003235.pub2

Li T, Vijayan A. Insulin for the treatment of hyperkalemia: a double-edged sword?. Clin Kidney J. 2014;7(3):239-241. doi:10.1093/ckj/sfu049

Summarized by Mason Tuttle| Edited by Nick Tsipis, MD

Episoder(1144)

Episode 980: Brain Injury Guidelines (BIG)

Episode 980: Brain Injury Guidelines (BIG)

Contributor: Aaron Lessen, MD Educational Pearls: Traumatic Brain Injuries are a frequent complaint in the Emergency Department and have increased in recent years. The American Association for Surgery...

27 Okt 20253min

Episode 979: Oral vs Temporal Thermometers

Episode 979: Oral vs Temporal Thermometers

Contributor: Taylor Lynch, MD Educational Pearls: A recent study published in a pediatric journal in April 2025 compared temporal and oral thermometers Paired temperature measurements (temporal and o...

20 Okt 20253min

Episode 978: Delusional Parasitosis

Episode 978: Delusional Parasitosis

Contributor: Taylor Lynch, MD Educational Pearls: Delusional parasitosis is a subtype of the psychiatric condition delusional disorder Defined as a fixed, false belief of infestation by parasites or...

13 Okt 20253min

Episode 977: Amyloid Therapy and Stroke-like Events

Episode 977: Amyloid Therapy and Stroke-like Events

Contributor: Aaron Lessen, MD Educational Pearls: The cause of Alzheimer's disease is multifactorial, but the most widely suspected mechanism is the amyloid cascade hypothesis: Beta-amyloid proteins ...

6 Okt 20253min

Episode 976: Improvised Burr Hole in an Epidural Hematoma

Episode 976: Improvised Burr Hole in an Epidural Hematoma

Contributor: Alec Coston, MD Case Report Summary: A 17-year-old female involved in a motor vehicle collision presented to a rural emergency facility via personally operated vehicle. During workup and ...

29 Sep 20254min

Episode 975: Nursemaid's Elbow

Episode 975: Nursemaid's Elbow

Contributor: Aaron Lessen, MD Educational Pearls: What is a Nursemaid's Elbow? A condition in which an elbow gets partially pulled out of place (a radial head subluxation) Usually happens in kids und...

22 Sep 20253min

Episode 974: ACE Inhibitor Angioedema

Episode 974: ACE Inhibitor Angioedema

Contributor: Ricky Dhaliwal, MD Educational Pearls: Angioedema in anaphylaxis Histamine and mast cell-mediated pathway Treatment: First line: epinephrine for vasoconstriction and bronchodilation Se...

15 Sep 20255min

Emergency Medicine Cases with Dr. Barlock

Emergency Medicine Cases with Dr. Barlock

Contributors: Travis Barlock MD, Jeffrey Olson MS4 Feel free to use the cases below for your own practice. All of the scenarios are completely made up and designed to hit several teaching points. Case...

9 Sep 202553min

Populært innen Vitenskap

fastlegen
tingenes-tilstand
smart-forklart
rekommandert
sinnsyn
jss
tomprat-med-gunnar-tjomlid
rss-rekommandert
forskningno
villmarksliv
rss-paradigmepodden
fjellsportpodden
diagnose
aldring-og-helse-podden
tidlose-historier
nevropodden
dekodet-2
nordnorsk-historie
rss-nysgjerrige-norge
hva-er-greia-med