Very interesting results of the RFN Poll of the Week regarding different opinions regarding managing the potassium bath in a patient with hyperkalemia!
Of the options give, there was a near three-way split between the first three answers (giving a 1K bath, giving a 2K bath, or a giving a 1K bath and then changing to a 2K bath after one hour). In my opinion, this speaks to the overall lack of data describing what one should do in managing hyperkalemia during dialysis! I would also imagine that an individual’s choice would be highly influenced as to where they trained or what the practice patterns are at their individual hospitals.
Personally, I was taught the “rule of 7’s”–the patient’s serum K plus their dialysate bath K should equal approximately 7. Unfortunately this tends to break down at higher potassium levels.
Check out the latest Thursday Poll of the Week question on the right!
I think the important factor for determining K bath in this case is patient's compliance to the diet (NO MORE BANANAS DISHES).If this patient is known non-compliant I will tend to use lower K bath.
Thanks again and again for this informative blog.Keep up the good work.
AK
I like the rule of 7's.. never heard that one.
Great job with the changes on the blog.
Keep up the good work!
SP
I think the ideal way to manage this problem is a step approach (3/2/1 etc) which will prevent a sudden change of K gradient to avoid potential dangerious cardiac issues