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

Avsnitt(1144)

Podcast 993: Personalized Gene Editing Therapy

Podcast 993: Personalized Gene Editing Therapy

Contributor: Alec Coston, MD Educational Pearls: Disclaimer: this has nothing to do with the ER but is too cool to not talk about. Condition: Carbamoyl phosphate synthetase 1 (CPS1) deficiency Ra...

9 Feb 6min

Tox Talks 2025 Recap 2, Methemoglobinemia and Errors

Tox Talks 2025 Recap 2, Methemoglobinemia and Errors

Contributors: Travis Barlock MD, Ian Gillman PA, Jacob Altholz MD, Jeffrey Olson MS4 In this episode, EM attending Travis Barlock and medical student Jeffrey Olson listen in to the two remaining cases...

4 Feb 41min

Podcast 992: Fentanyl for Asthma

Podcast 992: Fentanyl for Asthma

Contributor: Alec Coston, MD Educational Pearls: BiPAP is often effective in severe asthma, but many patients struggle with mask tolerance due to intense air hunger–driven anxiety, often compounded ...

2 Feb 4min

Episode 991: BRASH

Episode 991: BRASH

Contributor: Aaron Lessen, MD Educational Pearls BRASH Syndrome: Bradycardia Renal Failure AV Nodal Blockade Shock Hyperkalemia  Clinical Features: Profound bradycardia and shock in pat...

19 Jan 2min

Episode 990: Tramadol, or rather, Trama-don't

Episode 990: Tramadol, or rather, Trama-don't

Contributor: Taylor Lynch, MD Educational Pearls: What is tramadol and how does it work? Tramadol is a Schedule IV opioid analgesic used for moderate pain and is often perceived as safer than other ...

12 Jan 5min

Episode 989: Young Strokes

Episode 989: Young Strokes

Contributor: Aaron Lessen, MD Educational Pearls: The Case 24F brought in for anxiety. Patient is tearful, not talking, and potentially hyperventilating. History from boyfriend is that she suddenly ...

5 Jan 3min

Episode 988: Infant Botulism

Episode 988: Infant Botulism

Contributor: Aaron Lessen, MD Educational Pearls: A 2025 multistate outbreak of infant botulism has been linked to ByHeart infant formula As of December 10-17th, there have been at least 51 infants ...

29 Dec 20252min

Carepoint Journal Club: Trauma Discussion

Carepoint Journal Club: Trauma Discussion

Carepoint Journal Club is a quarterly series with discussions about a medical topic, brought to you by Carepoint's Emergency Physicians.

22 Dec 202545min

Populärt inom Vetenskap

p3-dystopia
svd-nyhetsartiklar
pojkmottagningen
dumma-manniskor
allt-du-velat-veta
kapitalet-en-podd-om-ekonomi
det-morka-psyket
rss-vetenskapsradion
rss-ufo-bortom-rimligt-tvivel
rss-experimentet
paranormalt-med-caroline-giertz
medicinvetarna
bildningspodden
halsorevolutionen
rss-vetenskapsradion-2
4health-med-anna-sparre
rss-spraket
hacka-livet
rss-broccolipodden-en-podcast-som-inte-handlar-om-broccoli
sexet