Abstract

RUIZ-MEJIA, R.; ORTEGA-OLIVARES, LM.; NARANJO-CARMONA, CA.  and  SUAREZ-OTERO, R.. Treatment of hyperkaliemia in patients with chronic renal disease and dialytic therapy. Med. interna Méx. [online]. 2017, vol.33, n.6, pp.778-796. ISSN 0186-4866.  https://doi.org/10.24245/mim.v33i6.1312.

Since the most important electrolytic alteration in chronic kidney disease is hyperkalemia, a review of the literature was conducted in the management of renal hyperkalemia in patients with chronic kidney disease and in dialysis therapy. Analysis of selected articles in PubMed Central, EBSCO, Medlineplus, SciELO under the title hyperkalemia, hyperkalemia management, hyperkalemia treatment and acute and chronic hyperkalemia (etiology, epidemiology, diagnostic methods and methods of classic and current treatments). Various review articles and treatment articles were analyzed in the pre-dialysis and dialysis stages. The articles that defined hyperkalemia as an elevation greater than 5 mEq/L in serum were analyzed and considered the etiology of excessive potassium intake, extracellular displacement and alteration in the elimination of potassium at the renal level, including clinical and laboratory manifestations. Also included was the analysis of articles that associated hyperkalemia with the development of renal failure, heart failure and with the use of drugs including renin angiotensin aldosterone system inhibitors, potassium-sparing diuretics and non-steroidal anti-inflammatory drugs. Treatment options for hyperkalemia in chronic kidney disease continue to be limited despite the development of new drugs, so the goal of treatment in both acute and chronic hyperkalemia is to reverse adverse effects primarily at the cardiac level, potassium at the intracellular level, eliminating the potassium at the corporal level, diminishing the symptoms and normalizing the serum concentrations of the same.

Keywords : hyperkalemia; chronic renal disease; end-stage renal failure; dialytic therapy.

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