Surreptitious hyperkalaemia and its complications.

Area of Science:

• Nephrology
• Internal Medicine
• Clinical Chemistry

Background:

• Surreptitious hyperkalemia is uncommon, especially in non-dialysis-dependent patients.
• Diagnostic challenges can arise, leading to complex investigations and proposed treatments.

Purpose of the Study:

• To present a case of baffling hyperkalemia.
• To illustrate a diagnostic approach prioritizing common etiologies.

Main Methods:

• Case report of a patient with unexplained hyperkalemia.
• Diagnostic workup focusing on anion composition.

Main Results:

• The hyperkalemia was ultimately attributed to the accompanying anion.
• A common cause was identified after initial complex hypotheses were considered.

Conclusions:

• Even in rare presentations, common diagnostic principles should guide investigations.
• Focusing on accompanying anions can resolve complex electrolyte disturbances like hyperkalemia.