Is There Too Much Variability in Hyperkalemia Management?


The virtually-held National Kidney Foundation 2020 Spring Clinical Meetings explored various topics relating to nephrological conditions, treatment, and patient outcomes. One presentation, spearheaded by Dr. Adam Weinstein, MD, and his team, highlighted the need for standardized hyperkalemia care. You can find his poster presentation here.


Hyperkalemia means heightened levels of potassium in the blood. At normal levels, potassium contributes to heart, nerve, and muscle function. But when levels of potassium rise above normal, it can lead to heart arrhythmia and damage.

This can result from Addison’s disease, Type 1 diabetes, alcoholism or drug use, a high-potassium diet, certain medications, burns and severe injuries, and kidney disease.

Some people with mild hyperkalemia may experience no symptoms. However, those with moderate to severe hyperkalemia may experience nausea and fatigue, muscle weakness, a weak or irregular pulse, and feeling “pins and needles” all over the body.

Learn more about hyperkalemia here.

The Study

Dr. Weinstein’s team examined the variability of hyperkalemia treatment using data sourced from 11 nephrology clinics nationwide. The data, which encompassed 343 patients over a 4 year period, showed that:

  • 154 patients (45%) had mild hyperkalemia, with 109 patients (32%) having moderate and 80 patients (23%) having severe.
  • Stage 3 or 4 chronic kidney disease was present in 63% of patients ages 60-79, 59% of male patients, and 68% of white patients.
  • 281 patients (82%) had hypertension, with 175 (51%) having diabetes, 127 (37%) having extra protein in the urine, and 27 (8%) having congestive heart failure.
  • A majority of patients were not being treated with diuretics, aldosterone blocking agents, or ACEIs.

Additionally, a potassium binder (which reduces potassium levels) was only given to 75 patients (22%). Researchers found that many doctors did not take the severity of each patient’s condition into account. Region and locale (urban vs. rural) also impacted care.

Ultimately, researchers affirmed that there is no standardized care practices for people with hyperkalemia. Variant clinical management strategies included:

  • Dietary counseling
  • Multiple blood tests
  • Medication (starting, stopping, and adjusting doses)
  • Referrals to other practices
  • Dialysis

But 117 patients (34%) received none of this! As a result, patients are missing the highest quality of care. Moving forward, the researchers advocate for the creation and implementation of standardized care practices for the rare condition.

Find the original article here.

Jessica Lynn

Jessica Lynn

Jessica Lynn has an educational background in writing and marketing. She firmly believes in the power of writing in amplifying voices, and looks forward to doing so for the rare disease community.

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