Sunday, 15 September 2013

Watch out for Hyperkalemia-- recap on management!


Approach to Hyperkalemia

Potassium: enters the body via oral intake or IV infusion and is largely stored in cells, and then is excreted in the urine. The major causes of hyperkalemia are increased K+ release from cells and most often, reduced urinary K+ excretion

Definition: depends on the lab; K>5-5.5

History: medications, history of AKI/CKD, excessive exercise, RTA IV

Clinical Symptoms:
·       Muscular: weakness and even paralysis of extremities; but rarely respiratory muscle involvement
·       Cardiac: palpitations, orthostatic symptoms if bradycardic (on ECG: tall, peaked T waves, especially in the precordial waves, widened QRS, wide and flat P wave, VF, VT and PEA can arise!)

DDx
·       “Pseudohyperkalemia” – hemolysed blood sample, leukocytosis, thrombocytosis
o   Due to K+ movement out of the cells during or after blood specimen has been drawn
o   Suspect when: no apparent cause for the hyperkalemia in an asymptomatic patient with normal ECG
o   Consider technique of venipuncture: try w/o tourniquet or the fist clenching (K+ moves out of cells with exercise!) or trauma to demonstrate a true serum K
o   K+ moves out of platelets after clotting has occurred
o   High WBC  (i.e. d/t CLL)à can falsely elevate K+ concentration d/t cell fragility
·       Increase Intake: RARE, unless it occurs acutely
o   K+ loadà some stays in ECFà mild elevation in plasma [K]à stimulates secretion of aldosteroneà enhances both Na+ reabsorption & K+ excretion by the principal cells
·       Trans-cellular Shift out of Cell: metabolic acidosis, insulin deficiency (DM), Beta-blockade, digoxin intoxication, cellular necrosis (i.e. tumour lysis, rhabdo, ischemic bowel)
o   Metabolic Acidosis: buffering excess H+ ions in the cellsàK+ movement into ECF, a transcellular shift obligated by the need to maintain electro-neutrality
o   Insulin deficiency, hyperglycemia, hyperosmolality: insulin normally promotes K+ entry into cells; shift in DKA, despite the fact that there may be marked deficit d/t urinary losses
o   Beta-Blockers: interfere with B2-adrenergic facilitation of K+ uptake by the cells, especially after a K+ load; primarily with non-selective BB (i.e. labetolol, propranolol)
·       Increase Release: rhabdomyolysis, tumor lysis, strenuous exercise, intravascular hemolysis
o   Increased tissue catabolism with increased breakdownà release of intracellular K into extra-cellular fluid
·       Decrease in Output:
o   Decrease in distal tubular flow: renal failure, decrease effective circulating volume
o   Hypoaldosteronism: decrease renin, adrenal insufficiency, Type IV RTA, ACEi/ARB, spironolactone, NSAIDs
Investigations:
·       CBC, lytes, extended lytes, Cr, Urea, glucose, serum osmolality, UA, urine lytes, urine osmolality, consider VBG
·       ECG: peaked T waves (pre-cordial leads), widened QRS, flattened P waves
·       Hypoaldosteronism work-up: serum aldosterone and plasma renin activity
Measurement of 24h urinary K+ excretion: of limited utility in patients with persistent, stable hyperkalemia;
·       The trans-tubular K+ gradient is NOT a reliable test for the diagnosis of hyperkalemia

NOTE: most healthy patients can handle large K+ loads with only a small rise in serum K+; thus, the most common cause of persistent hyperkalemia, is associated with impaired urinary K+ excretion d/t reduced secretion of or response to aldosterone, AKI/CKD, and/or effective arterial blood volume depletion

Management
·       Indications for Acute management:  ECG changes + hyperkalemia (i.e. K>6-6.5), serum K>6.5-7 even if no ECG changes, serum K is rapidly increasing
Place patient on a cardiac monitor

Stabilize the cardiac membrane: Calcium Gluconate 10%, 10mL (1000 mg) IV push over 2 min, with a cardiac monitor on!
o   Antagonizes the membrane actions of hyperkalemia (Calcium is also helpful, as hypocalcemia increases the cardiotoxicity of hyperkalemia)
o   Hyperkalemia induced depolarization of resting membrane potential leads to deactivation of Na channels and decreased membrane excitability
o   Effect begins within minutes; but only lasts 30-60 minutes!
o   CaCl contains 3x the concentration of elemental Ca then Ca Gluconate
§  CaClà500-1000 mg (5 to 10 mL of a 10% solution), infused over 2 min
o   Concentrated Ca infusions: irritating to veins and extravasation can cause tissue necrosis; central/deep vein line= preferred! DO NOT GIVE IN HCO3 solution àcan cause precipitation of Calcium Gluconate
·       What about Digoxin?? Hypercalcemia potentiates the cardio-toxic effects of digitalis;
o   Ca should still be given for the appropriate indications…
o   In these patients, use a dilute solution, administered slowly (i.e. 10 mL of 10% Calcium Gluconate in 100 mL of 5% dextrose in water over 30 minutes)
Shift K+ into the cells: Insulin, NaHCO3, short acting beta-agonist (SABA)
·       Insulin & D50: given an amp of D50 (i.e. 50 mL push—25 g of glucose), followed by Regular Insulin 10 units IV
o   Drives K into cells, via enhancing the activity of the Na-K-ATPAse pump
o   Usually give with D50; given insulin alone if BG >14
o   Effect of insulin: within 10-20 minutes; peak at 60 min, lasts 4-6 h

o   Create Alkalosis: NaHCO3 1 amp IV over 5 minutes; raise systemic pH, resulting in H+ ion release from the cells as part of the buffering reaction; K+ moves into cells to maintain electro-neutrality

§  Alternative: 150 mEq in 1L of 5% dextrose in water over 2-4 h
o   Beta-Agonist: ventolin 2-4 puff INH
o   Monitor HR, cardiac monitor
o   Measure K and other lytes: 1-2 hours after initiation of therapy
o   Serial ECGs
·       Removal of K+:
o   Kayexalate 30g PO daily- QID, each dose followed by lactulose 30 mL PO
§  MOA: removes K by exchanging Na ions for K ions in the intestine, especially in the LI before the resin is passed from the body
§  Follow with  lactulose
o   Ca resonium
o   Diuretics (i.e. Lasix 40 mg IV)
o   If refractory—Dialysis
·       Treat underlying cause
o   Discontinue offending drug: K+ sparing diuretic, ARB/ACEi, K+ supplement, NSAID, TMP

ARTICLE: here is a short review (it's an older article, but there are good cases and ECGs) out of Emergency Medicine (2002), titled "Recognising signs of danger: ECG changes resulting from an abnormal serum potassium concentration" 

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