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Updated: Apr 29, 2026

Exploring Arterial Smooth Muscle Kv7 Potassium Channel Function using Patch Clamp Electrophysiology and Pressure Myography
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Sailing between Scylla and Charybdis: the high serum K-low dialysate K quandary

Laura Labriola1, Michel Jadoul

  • 1Department of Nephrology, Cliniques universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium.

Seminars in Dialysis
|May 15, 2014
PubMed

In HD patients, the optimal choice of dialysate K concentration is of paramount importance. Recent large observational studies have documented an association between low dialysate K concentration (< 2 or even <3 mEq/L) and a higher risk of sudden death. In this review, we first briefly discuss the available data concerning the link between hypokalemia and negative outcomes in non-CKD populations, especially after an acute myocardial infarction or in congestive heart failure. We next review the pathophysiology of the arrhythmogenic effect related to K fluxes during HD and discuss the dialytic strategies aiming at making potassium fall more gradual and thus at reducing the electrical disturbances triggered by the HD session. We conclude with practical recommendations regarding the optimal choice of K bath and the importance of more frequent monitoring of serum K in some clinical scenarios.

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