![]() ![]() 3 Finally, excessive body potassium can be removed with sodium polystyrene sulfonate (Kayexalate), whereas hemodialysis represents the definitive method to reduce serum potassium levels. 2 Sodium bicarbonate, beta-2 adrenergic agonists, and the combination of glucose and insulin all drive potassium intracellularly and lower the extracellular serum potassium level. Changes in the cardiac conduction system are usually evidenced by ECG changes, which may indicate potentially life-threatening arrhythmias. Cardiac and neuromuscular cells are most sensitive to changes in serum potassium concentrations. 3 Calcium (intravenous calcium chloride or gluconate) can effectively block the effect of extracellular potassium elevation on cardiac myocytes within minutes by restoring a more appropriate electrical gradient across the cellular membrane. Most clinical consequences of hyperkalemia are related to the effect on transmembrane resting cell potential. 1– 3 Treatment of life-threatening hyperkalemia focuses on blocking the effects on myocyte transmembrane potential and cardiac conduction, as well as decreasing extracellular potassium levels. ![]() Typical ECG findings in hyperkalemia progress from tall, “peaked” T waves and a shortened QT interval to lengthening PR interval and loss of P waves, and then to widening of the QRS complex culminating in a “sine wave” morphology and death if not treated. Learn more about the symptoms, causes, and treatments of hyperkalemia. Diagnosis of hyperkalemia is usually based on laboratory studies, although the electrocardiogram (ECG) may contain changes suggestive of hyperkalemia. Hyperkalemia is a relatively silent electrolyte problem, but it can be fatal. ![]()
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