General consideration :
Usually develops in patient with advanced renal dysfunction .It is also associated with acidosis.
Mineralocorticoid deficiency from Addison disease(high renin) or chronic kidney disease
(low rennin) is another cause of hyperkalemia.
ACE inhibitors ,ARBs and potassium –sparing diuretics ,commonly used with congestive heart failure or chronic kidney disease may cause hyperkalemia .
Heparin, trimethoprim,amiloride,triamterene and immunosuppressive drugs such as cyclosporine and tacrolimus can induce hyperkalemia.
Muscle weakness,rarely,flaccid paralysis ,abdominal distention and diarrhea may occure.
ECG is not a sensitive method for detecting hyperkalemia.ECG changes include peaked Twaves of increased amplitude , widening of QRS<and biphasic QRS-T complex.
The heart rate may be slow ,ventricular fibrillation and cardiac arrest are terminal events.
Calcium :antagonizes cardiac conduction abnormalities .
Bicarbonate ,insulin ,albuterol:distributes K into cells .
Loop diuretic:(furosemide)increase renal K excretion.
Sodium polystyrene sulfonate.
Hemodialysis or peritoneal dialysis.