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Published on: July 15, 2015
Potassium balances in maintenance hemodialysis
1Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
Electrolyte & Blood Pressure : E & BP
|August 16, 2013
Summary
Dyskalemia, or electrolyte imbalance, is common in hemodialysis patients. Both hyperkalemia and hypokalemia can be serious, contributing to mortality and reduced life expectancy in end-stage renal disease (ESRD) patients.
Area of Science:
- Nephrology
- Internal Medicine
- Clinical Chemistry
Background:
- Potassium is primarily intracellular, with renal excretion dominating.
- Dyskalemia (potassium imbalance) is prevalent in maintenance hemodialysis (HD) patients.
- End-stage renal disease (ESRD) patients on HD face increased mortality, with dyskalemia as a contributing factor.
Purpose of the Study:
- To highlight the significance of dyskalemia in maintenance hemodialysis patients.
- To discuss the prevalence and risks associated with hyperkalemia and hypokalemia in this population.
- To underscore dyskalemia as a factor in the excess mortality of ESRD patients.
Main Methods:
- Literature review and analysis of existing data on dyskalemia in hemodialysis.
- Examination of prevalence rates for hyperkalemia and hypokalemia.
- Review of mortality data and causes in ESRD patients undergoing maintenance HD.
Main Results:
- Hyperkalemia affects 8.7-10% of maintenance HD patients and is linked to significant mortality.
- Severe hyperkalemia necessitates emergency hemodialysis in a notable percentage of patients.
- Hypokalemia, though less common, arises from factors like malnutrition and certain medications.
Conclusions:
- Dyskalemia is a critical, often overlooked, complication in maintenance hemodialysis.
- Effective management of potassium levels is crucial for improving outcomes and survival in ESRD patients.
- Further attention to both hyperkalemia and hypokalemia is warranted in the care of hemodialysis patients.
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