Standardising dialysate potassium does not increase patient risk

Rapid intradialytic potassium shifts during haemodialysis have been associated with increased mortality and morbidity. Standardising dialysate potassium to 2 mmol/l may decrease the potassium shift.

To examine the effect of standardising dialysate potassium to 2 mmol/l for all chronic dialysis treatments.

Pre- and post-intervention comparison of monthly serum potassium.

Ninety-seven individuals, of whom 56 patients could be matched across both data collection periods.

Serum potassium data were categorised based on a target range 3.5-6.0 mmol/l. Overall pre- and post-intervention mean scores were compared using a paired samples t-test. Data for patients routinely prescribed dialysate potassium 1 mmol/l pre-intervention (n = 6) underwent paired samples t-test to compare their mean serum potassium pre- and post-intervention.

There was no statistically significant change in serum potassium post-intervention. The majority of patients remained within the target range, including the subset of patients who had a history of high serum potassium during the pre-intervention period.

A standard potassium dialysate of 2 mmol/l may reduce intradialytic serum potassium shifts and may assist in standardising safer work practices.