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Surprising Hyperkalemia of 10.2 mmol/L in a Patient with Hyperglycemia: A Case Report

Authors
  • Czogalla, Jan
  • Tariparast, Pischtaz Adel
  • Huber, Tobias B.
  • Janneck, Matthias
  • Grahammer, Florian
Type
Published Article
Journal
Case Reports in Nephrology and Dialysis
Publisher
S. Karger AG
Publication Date
Feb 25, 2021
Volume
11
Issue
1
Pages
69–77
Identifiers
DOI: 10.1159/000512590
PMID: 33829044
PMCID: PMC7991282
Source
Karger
Keywords
License
Green
External links

Abstract

Hyperkalemia is a life-threatening condition potentially leading to cardiac arrest. Here, we report a case of surprising severe hyperkalemia of 10.2 mmol/L in a diabetic patient with previously normal kidney function presenting without discernible clinical symptoms to our emergency department. The patient was admitted because of hyperglycemia of 32.8 mmol/L, which was detected during daily testing in her nursing home. The hyperkalemia was caused by prerenal failure due to hyperglycemic polyuria which led to volume depletion, and worsened by a combination of potassium-sparing drugs and potassium supplementation. The patient was treated conservatively. Eighteen hours later, the serum potassium concentration was 4.6 mmol/L. The patient could be released 6 days later. To our knowledge, this is the highest described hyperkalemia treated conservatively and survived without cardiopulmonary resuscitation.

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