Investigating hyperkalaemia in adults
BMJ 2015; 351 doi: https://doi.org/10.1136/bmj.h4762 (Published 20 October 2015) Cite this as: BMJ 2015;351:h4762All rapid responses
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Thank you for a really useful summary of the management of hyperkalaemia, which is a common clinical problem.
Another medication to add to the list of potassium-containing drugs is raltegravir. Raltegravir is an antiretroviral increasingly used to treat HIV infection (http://www.bhiva.org/documents/Guidelines/Treatment/2015/2015-treatment-...).
The active drug is a potassium salt (http://www.medicines.org.uk/emc/medicine/20484/SPC/) and therefore care needs to be taken if using in people with renal impairment.
Competing interests: No competing interests
Salt substitutes are widely available and advertised as “a great route to reducing the sodium in your diet”. They may contain up to 66% Potassium chloride.
I have managed numerous emergency admissions with isolated hyperkalaemia or hyperkalaemia associated with cardiac disease / cardiac medication caused by salt substitutes.
“Do you take a salt substitute?” is now one of my first questions to ask.
Competing interests: No competing interests
The role of cation-exchange resins in hyperkalemia
In their very useful article Dr McDonald and his colleagues summarise the investigations and management of hyperkalemia. The use of cation-exchange resins was omitted from the management plan. However, this category is suggested by the UK Renal Association in mild-to-moderate hyperkalaemia, as well as in severe hyperkalaemia, in circumstances where dialysis is delayed or inappropriate. Excluding dialysis, cation-exchange resins are the only way of removing potassium from the body and therefore they should always be considered.
Competing interests: No competing interests