Review of Hyperkalemia in End Stage Renal Disease

Potassium balance is maintained in the body by balancing the intake with the excretion and the transcellular shifts of potassium. Excretion of potassium is mainly renal as the contribution of the colon to the net potassium secretion of the colon to the net potassium secretion is trivial in patients with normal renal function. As the majority of potassium excretion is renal, it is not surprising to note that patients with end stage renal disease (ESRD) are at an increased risk of developing hyperkalemia in ESRD patients has been estimated to be 3-5%. Maintenance of a stable serum potassium level in patients with ESRD is crucial. We will review the various measures for the management and prevention of hyperkalemia in ESRD patients such as dietary restrictions, dialysis and drugs enhancing extra renal elimination of potassium.