For the full versions of these articles see bmj.com CLINICAL REVIEW Hyperkalaemia Moffat J Nyirenda,1 Justin I Tang,1 Paul L Padfield,2 Jonathan R Seckl1 1Endocrinology Unit, Centre for Hyperkalaemia is defined as serum potassium concen- SUMMARY POINTS Cardiovascular Science, Queen’s tration greater than 5.5 mmol/l. Its prevalence in the Medical Research Institute, Hyperkalaemia is usually caused by a combination of University of Edinburgh, Edinburgh general population is unknown, but it is thought to occur factors, but renal failure and drugs are often implicated 1 EH16 4TJ in 1-10% of patients admitted to hospital. The rate of Increased use of drugs that interact with the renin- 2Metabolic Unit, Western General morbidity and mortality associated with hyperkalaemia angiotensin-aldosterone system has caused the Hospital, Lothian University has risen greatly with the use of drugs that target the prevalence of hyperkalaemia to rise Hospitals NHS Trust, Edinburgh renin-angiotensin system, and since publication 10 years Correspondence to: M Nyirenda Hyperkalaemia can cause life threatening cardiac
[email protected] ago of a randomised trial that showed that adding an arrhythmias and should be urgently managed aldosterone receptor antagonist to usual treatment for ECG changes correlate poorly with the degree of potassium Cite this as: BMJ 2009;339:b4114 congestive failure improved outcomes.2-5 disturbance doi: 10.1136/bmj.b4114 Potassium is the most abundant cation in the human body and has key roles in the excitatory properties range from 40 mmol to 200 mmol per day, potassium needed for conduction of nerve impulses and muscle levels in serum remain within the relatively narrow contraction.