Current treatment and unmet needs of hyperkalaemia in the emergency department
Open Access
- 1 February 2019
- journal article
- research article
- Published by Oxford University Press (OUP) in European Heart Journal Supplements
- Vol. 21 (Supplement), A12-A19
- https://doi.org/10.1093/eurheartj/suy029
Abstract
Hyperkalaemia is a common electrolyte abnormality and can cause life-threatening cardiac arrhythmia. Even though it is common in patients with diabetes, heart failure, and kidney disease, there is poor consensus over its definition and wide variability in its treatment. Medications used to treat hyperkalaemia in the emergent setting do not have robust efficacy and safety data to guide treatment leading to mismanagement due to poor choice of some agents or inappropriate dosing of others. Moreover, the medications used in the emergent setting are at best temporizing measures, with dialysis being the definitive treatment. New and old k binder therapies provide means to excrete potassium, but their roles are unclear in the emergent setting. Electrocardiograms are the corner stones of hyperkalaemia management; however, recent studies show that they might manifest abnormalities infrequently, even in severe hyperkalaemia, thus questioning their role. With an aging population and a rise in rates of heart and kidney failure, hyperkalaemia is on the rise, and there is a need, now more than ever, to understand the efficacy and safety of the current medications and to develop newer ones.Keywords
This publication has 106 references indexed in Scilit:
- Gene Expression-Based Classifiers Identify Staphylococcus aureus Infection in Mice and HumansPLOS ONE, 2013
- Evaluation of the efficacy and safety of RLY5016, a polymeric potassium binder, in a double-blind, placebo-controlled study in patients with chronic heart failure (the PEARL-HF) trialEuropean Heart Journal, 2011
- Pathogenesis, diagnosis and management of hyperkalemiaPediatric Nephrology, 2010
- Management of patients with acute hyperkalemiaCMAJ : Canadian Medical Association Journal, 2010
- The Frequency of Hyperkalemia and Its Significance in Chronic Kidney DiseaseArchives of Internal Medicine, 2009
- Retrospective Review of the Frequency of ECG Changes in HyperkalemiaClinical Journal of the American Society of Nephrology, 2008
- Electrocardiographic manifestations of hyperkalemiaThe American Journal of Emergency Medicine, 2000
- Prolonged Asystolic Hyperkalemic Cardiac Arrest With No Neurologic SequelaeAnnals of Emergency Medicine, 1994
- The ability of physicians to predict hyperkalemia from the ECGAnnals of Emergency Medicine, 1991
- A Clinical Correlative Study of the Electrocardiogram in Electrolyte ImbalanceCirculation, 1956