The Frequency of Hyperkalemia and Its Significance in Chronic Kidney Disease

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Abstract
Chronic kidney disease (CKD) is a common disease,1 affecting a growing number of Americans, and it may be associated with a variety of electrolyte disturbances.2 One such disturbance, hyperkalemia, is of great concern to providers who are treating patients with CKD because of its possible implications for patient safety related to the potential for associated adverse cardiac outcomes.3-6 Patients with CKD may be predisposed to hyperkalemia for a variety of reasons. Principal causes include an impaired glomerular filtration rate (GFR) combined with a frequently high dietary potassium intake relative to residual renal function, a commonly observed extracellular shift of potassium caused by the metabolic acidosis of renal failure,2,3 and, most importantly, recommended treatment with renin-angiotensin-aldosterone system (RAAS) blockers that inhibit renal potassium excretion.7-9