Hyperkalemia in CKD: From Emergency Management to Prevention

• Dr. Mahmoud Saad Abdelwahab Younes — Nephrology Consultant, Town Hospital EG, Cairo

Nephrology

Hyperkalemia is a frequent and potentially life-threatening complication of chronic kidney disease (CKD), arising from impaired renal potassium excretion and compounded by factors such as medications, metabolic disturbances, and dietary intake. Clinical management requires prompt recognition and risk stratification, particularly when severe hyperkalemia or electrocardiographic abnormalities are present. Acute treatment focuses on stabilising the cardiac membrane, shifting potassium intracellularly, and removing excess potassium from the body. Beyond emergency management, strategies to reduce recurrence include optimisation of contributing medications and comorbidities, dietary considerations, and appropriate use of potassium-lowering therapies. Regular monitoring of serum potassium and kidney function remains essential, particularly in patients receiving renin-angiotensin-aldosterone system inhibitors.