{"id":5349,"date":"2021-01-29T13:08:11","date_gmt":"2021-01-29T13:08:11","guid":{"rendered":"https:\/\/edren.org\/ren\/?page_id=5349"},"modified":"2023-04-03T14:10:11","modified_gmt":"2023-04-03T14:10:11","slug":"hyperkalaemia-outpatient","status":"publish","type":"page","link":"https:\/\/edren.org\/ren\/handbook\/unithdbk\/fluids-and-electrolytes\/hyperkalaemia-outpatient\/","title":{"rendered":"Hyperkalaemia (outpatient)"},"content":{"rendered":"

Hyperkalaemia in the community<\/strong><\/h1>\n

Hyperkalaemia detected in the community is a frequent reason for referral to secondary care.\u00a0 These pages are designed to assist decision-making in primary care.\u00a0 We also have guidance on management of hyperkalaemia in hospital<\/a>.<\/p>\n

 <\/p>\n

Expert guidelines<\/strong><\/h3>\n

1) Treatment of acute hyperkalaemia in adults (July 2020)<\/em><\/a>: the UK Renal Association Clinical Practice Guideline.\u00a0 This gives very comprehensive advice on hyperkalaemia (is 161 pages long).\u00a0 The flow-chart on p156 on “Management of Hyperkalaemia in the Community” recommends a simple management algorithm.<\/p>\n

2) \u2018<\/span>Change in renal function associated with drug treatment in heart failure: national\u00a0guidance (January 2019)<\/em><\/a>\u2019<\/em> . These joint cardiology-renal guidelines specifically address patients with heart failure (in whom there may be a strong rationale to continue renin-angiotensin inhibitors).\u00a0 Table 2 gives a suggested management algorithm.<\/p>\n

 <\/p>\n

Our recommendations for the <\/strong>management of hyperkalaemia in primary care:<\/strong><\/h3>\n

Based on our experience of referrals from primary care, we have used the relevant recommendations from these expert guidelines to help answer the most commonly asked questions:<\/p>\n

    \n
  1. Should this patient come to hospital for assessment and treatment?<\/em><\/li>\n
  2. If they don\u2019t need to come to hospital, when should the potassium be re-checked?<\/em><\/li>\n
  3. Should renin-angiotensin-aldosterone system inhibitors be stopped? <\/em><\/li>\n
  4. What other factors should be addressed to prevent recurrence?<\/em><\/li>\n<\/ol>\n

     <\/p>\n

    Suggested management algorithm:<\/strong><\/h5>\n

    \"\"<\/a><\/p>\n

    Most patients requiring urgent assessment in hospital should be referred to acute medicine or the emergency department using standard referral pathways.\u00a0 (Patients with pre-existing advanced CKD or heart failure may referred to the nephrology or cardiology teams but will often have to be admitted via<\/em> acute medicine.)<\/p>\n

     <\/p>\n

    Notes and rationale:<\/strong><\/h5>\n

    The most important principles are:<\/p>\n