Survival of extreme hyperkalemia

Severe hyperkalemia has been reported to lead to typical ECG changes, often reflecting cardiac abnormalities which finally lead to death in arrhythmias. The present report describes a 77-year-old male, who developed extreme hyperkalemia because of treatment with a potassium saving diuretic in combination with potassium supplementation and subsequent development of urinary retention. In spite of a maximal potassium value of 10.1 mmol/l only non-specific ECG-changes were found. The patient survived after an uneventful dialysis. Thus, extreme hyperkalemia may occur without typical ECG changes and serum potassium values exceeding 10 mmol/l may be survived.