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Potassium and Other Electrolytes

The kidneys play a major role in excretion of potassium. Potassium excretion can be impaired in patients with CKD, especially with the use of renin-angiotensin system (RAS) blockers. Patients with CKD should be monitored for hyperkalemia especially with changes in their medications. If hyperkalemia is detected, it should be treated in a timely fashion and referral to a nephrologist should be considered to assist with its management.

Other electrolyte disturbances in CKD include hyperphosphatemia, hypermagnesemia, and acidosis. When providing medications like bowel preps, antacids, or laxatives to patients with kidney disease, one should consider whether the patient will be able to adequately handle the electrolytes contained in such preparations.

Bakris GL, Weir MR. Angiotensin-converting enzyme inhibitor-associated elevations in serum creatinine: is this a cause for concern?Arch Intern Med. 2000 Mar 13;160(5):685-93.

Palmer BF.Managing hyperkalemia caused by inhibitors of the renin-angiotensin-aldosterone system.N Engl J Med. 2004 351(6):585-92.

Obialo CI, Ofili EO, Mirza T. Hyperkalemia in congestive heart failure patients aged 63 to 85 with subclinical renal disease. Am J Cardiol 2002 663-666.

Last Updated - May 08 2017 15:25:51.

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