Managing Hyperkalemia in the Modern Era: A Case-Based Approach

David Massicotte-Azarniouch; Mark Canney; Manish M Sood; Gregory L Hundemer

doi:10.1016/j.ekir.2023.04.016

Managing Hyperkalemia in the Modern Era: A Case-Based Approach

Kidney Int Rep. 2023 Apr 24;8(7):1290-1300. doi: 10.1016/j.ekir.2023.04.016. eCollection 2023 Jul.

Authors

David Massicotte-Azarniouch^{1

2}, Mark Canney^{1

2}, Manish M Sood^{1

2}, Gregory L Hundemer^{1

2}

Affiliations

¹ Department of Medicine, University of Ottawa at The Ottawa Hospital, Ottawa, Ontario, Canada.
² Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.

Abstract

The last decade has seen tremendous advances in the prevention and treatment of recurrent hyperkalemia. In this narrative review, we aim to highlight contemporary data on key areas in the epidemiology and management of hyperkalemia. Focusing on drug-induced hyperkalemia (the implications of renin-angiotensin-aldosterone system inhibitors [RAASi] discontinuation and the role of mineralocorticoid receptor antagonists), newer concurrent therapies that modify potassium handling (sodium-glucose transporter 2 inhibitors [SGLT2i]), the introduction of new treatment agents (oral potassium binding agents), and the controversial role of dietary potassium restriction, we apply recent research findings and review the evidence in a case-based format.

Keywords: dietary potassium; diuretics; hyperkalemia; novel potassium binders; renin-angiotensin-aldosterone inhibitors (RAAS inhibitors); sodium-glucose transporter 2 inhibitors (SGLT2 inhibitors).

Publication types

Review