Management of Hyperkalemia: Clinical Experiences in Northern Ireland

Due to the critical physiological role of potassium, development of  hyperkalemia requires effective management designed to reduce complications that include muscle weakness, paralysis, and cardiac arrhythmias. Patricia Campbell, MD, and colleagues at several hospitals in Northern Ireland, took part in a roundtable discussion on guidance for the use of potassium binders in patients with heart failure and/or chronic kidney disease (CKD). The discussion was reported online in the British Journal of Hospital Medicine [doi.org/10.12968/hmed.2021.0215]. Hyperkalemia commonly results from the failure of renal adaption to an imbalance of potassium. Patients with heart failure and those with CKD are particularly susceptible to the development of hyperkalemia. Individuals in those patient populations are often treated with renin-angiotensin- aldosterone system (RAAS) inhibitors, including angiotensin-converting enzyme inhibitors and angiotensin II-receptor blockers. However, the development of hyperkalemia may require down-titration or discontinuation of RAAS inhibitors, presenting nephrologists, cardiologists, and healthcare professionals treating patients with heart failure and/or CKD with significant challenges. The roundtable discussion centered on the panelists’ clinical experience using potassium binders in the management of hyperkalemia in Northern Ireland in patients with heart failure and/or CKD. The discussion included case studies as well as recommendations for the implementation and maintenance of chronic potassium-lowering treatment.