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Hyperkalemia in the emergency department: Etiology, symptoms and outcome of a life threatening electrolyte disorder

2013; Elsevier BV; Volume: 24; Issue: 5 Linguagem: Inglês

10.1016/j.ejim.2013.02.010

1879-0828

Carmen Andrea Pfortmüller, Alexander Leichtle, Martin Fiedler, Aristomenis K. Exadaktylos, Gregor Lindner,

Renal function and acid-base balance

Electrolyte disorders are common in the emergency department (ED). Studies investigating disorders in serum sodium and potassium exist both for hospitalized noncritically ill patients as well as for critically ill patients [ 1 Funk G.C. Lindner G. Druml W. Metnitz B. Schwarz C. Bauer P. et al. Incidence and prognosis of dysnatremias present on ICU admission. Intensive Care Med. 2010; 36: 304-311 Crossref PubMed Scopus (264) Google Scholar , 2 Palevsky P.M. Bhagrath R. Greenberg A. Hypernatremia in hospitalized patients. Ann Intern Med. 1996; 124: 197-203 Crossref PubMed Scopus (264) Google Scholar , 3 Darmon M. Timsit J.F. Francais A. Nguile-Makao M. Adrie C. Cohen Y. et al. Association between hypernatraemia acquired in the ICU and mortality: a cohort study. Nephrol Dial Transplant. 2010; 25: 2510-2515 Crossref PubMed Scopus (135) Google Scholar , 4 Lindner G. Funk G.C. Schwarz C. Kneidinger N. Kaider A. Schneeweiss B. et al. Hypernatremia in the critically ill is an independent risk factor for mortality. Am J Kidney Dis. 2007; 50: 952-957 Abstract Full Text Full Text PDF PubMed Scopus (213) Google Scholar ]. Although studies showed that disorders of both serum sodium as well as potassium are independently associated with adverse outcome in various patient populations, only little data has been published on dyskalemias in the ED [ 1 Funk G.C. Lindner G. Druml W. Metnitz B. Schwarz C. Bauer P. et al. Incidence and prognosis of dysnatremias present on ICU admission. Intensive Care Med. 2010; 36: 304-311 Crossref PubMed Scopus (264) Google Scholar , 4 Lindner G. Funk G.C. Schwarz C. Kneidinger N. Kaider A. Schneeweiss B. et al. Hypernatremia in the critically ill is an independent risk factor for mortality. Am J Kidney Dis. 2007; 50: 952-957 Abstract Full Text Full Text PDF PubMed Scopus (213) Google Scholar , 5 Polderman K.H. Schreuder W.O. Strack van Schijndel R.J. Thijs L.G. Hypernatremia in the intensive care unit: an indicator of quality of care?. Crit Care Med. 1999; 27: 1105-1108 Crossref PubMed Scopus (148) Google Scholar , 6 Alderman M.H. Piller L.B. Ford C.E. Probstfield J.L. Oparil S. Cushman W.C. et al. Clinical significance of incident hypokalemia and hyperkalemia in treated hypertensive patients in the antihypertensive and lipid-lowering treatment to prevent heart attack trial. Hypertension. 2012; 59: 926-933 Crossref PubMed Scopus (64) Google Scholar , 7 Goyal A. Spertus J.A. Gosch K. Venkitachalam L. Jones P.G. Van den Berghe G. et al. Serum potassium levels and mortality in acute myocardial infarction. JAMA. 2012; 307: 157-164 Crossref PubMed Scopus (245) Google Scholar ]. No single study exists on the prevalence, etiology and outcome of hyperkalemia in ED patients. Thus, we wanted to determine the prevalence, symptoms, etiology and outcome of severe hyperkalemia in the ED of a large university hospital.